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. 2018 May;32(5):2249-2254.
doi: 10.1007/s00464-017-5918-x. Epub 2018 Mar 1.

Quality of life after robot-assisted transmediastinal radical surgery for esophageal cancer

Shuntaro Yoshimura  1 , Kazuhiko Mori  2 , Yukinori Yamagata  3 , Susumu Aikou  1 , Koichi Yagi  1 , Masato Nishida  1 , Hiroharu Yamashita  1 , Sachiyo Nomura  1 , Yasuyuki Seto  4
Affiliations

Quality of life after robot-assisted transmediastinal radical surgery for esophageal cancer

Shuntaro Yoshimura et al. Surg Endosc. 2018 May.

Abstract

Background: The aim of this retrospective study was to assess postoperative quality of life (QOL) after robot-assisted radical transmediastinal esophagectomy, defined as a nontransthoracic esophagectomy with radical mediastinal lymphadenectomy combining a robotic transhiatal approach and a video-assisted cervical approach. The results were compared to those of transthoracic esophagectomy.

Methods: In this study, all consecutive patients who underwent robot-assisted radical transmediastinal esophagectomy or transthoracic esophagectomy for esophageal cancer at University of Tokyo between January 2010 and December 2014 were included. The European Organization for Research and Treatment of Cancer (EORTC)'s quality of life questionnaires QLQ-C30 and QLQ-OES18 were sent to all patients that were still living, had no recurrence or other malignancy, and had not undergone a reoperation because of complications after esophagectomy.

Results: We were able to survey 63 (98.4%) of 64 eligible patients. We assessed and compared the QOL scores of both groups of patients. Compared to transthoracic esophagectomy, transmediastinal esophagectomy was associated with better QOL. Global health status and the physical, role, and cognitive function scale scores were significantly superior in the transmediastinal esophagectomy group (P = 0.004, < 0.0001, 0.007, 0.002, respectively). Fatigue, nausea and vomiting, pain, appetite loss, reflux, and taste scores were significant lower (superior) in the transmediastinal esophagectomy group (P = 0.003, 0.032, 0.025, 0.018, 0.001, 0.041, respectively).

Conclusions: This study indicates that robot-assisted radical transmediastinal esophagectomy is associated with better postoperative QOL compared to transthoracic esophagectomy. A larger study and prospective analyses are needed to confirm the current results.

Keywords: Esophagectomy; Esophagus cancer; Minimally invasive esophagectomy; Quality of life; Robot-assisted esophagectomy.

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Conflict of interest statement

The contributions of the authors to this study are as described here: Shuntaro Yoshimura, Kazuhiko Mori, and Yasuyuki Seto are the authors mainly responsible for the study’s conception and design, acquisition of data, and analysis and interpretation of data. Yukinori Yamagata, Susumu Aikou, Koichi Yagi, Masato Nishida, Hiroharu Yamashita, and Sachiyo Nomura contributed mainly to the drafting of the article and to revising it critically for important intellectual content. Yasuyuki Seto contributed most importantly by giving final approval to the version to be submitted and revised versions to be published. Drs. Shuntaro Yoshimura, Kazuhiko Mori, Yukinori Yamagata, Susumu Aikou, Koichi Yagi, Masato Nishida, Hiroharu Yamashita, Sachiyo Nomura, and Yasuyuki Seto have no conflicts of interest or financial ties to disclose.

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