Two Cases of Robot-Assisted Totally Minimally Invasive Esophagectomy with Colon Interposition for Gastroesophageal Junction Cancer: Surgical Considerations

• Published in: Journal of chest surgery 2024-02, Vol.57 (3), p.323-327
• Main Authors: Shin, Kinam, Kim, In Ha, Jeon, Yun-Ho, Gong, Chung Sik, Kim, Chan Wook, Kim, Yong-Hee
• Format: Article
• Language: English
• Subjects: Case Report; case reports; colon interposition; minimally invasive surgical procedures; robotic surgical procedures
• ISSN: 2765-1606; 2765-1614
• DOI: 10.5090/jcs.23.131

This case report presents 2 patients with gastroesophageal junction cancer who both underwent totally minimally invasive esophagectomy with colon interposition. Patients 1 and 2, who were 43-year-old and 78-year-old men, respectively, had distinct clinical presentations and medical histories. Patient 1 underwent minimally invasive robotic esophagectomy with a laparoscopic total gastrectomy, colonic conduit preparation, and intrathoracic esophago-colono-jejunostomy. Patient 2 underwent completely robotic total gastrectomy, colon conduit preparation, and intrathoracic esophago–colono–jejunostomy. The primary challenge in colon interposition is assessing colon vascularity and ensuring an adequate conduit length, which is critical for successful anastomosis. In both cases, we used indocyanine green fluorescence angiography to evaluate vascularity. Determining the appropriate conduit is challenging; therefore, it is crucial to ensure a slightly longer conduit during reconstruction. Because totally minimally invasive colon interposition can reduce postoperative pain and enhance recovery, this surgical technique is feasible and beneficial.