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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 21, 2016; 22(19): 4626-4637
Published online May 21, 2016. doi: 10.3748/wjg.v22.i19.4626
Minimally invasive surgery for upper gastrointestinal cancer: Our experience and review of the literature
Koichi Suda, Masaya Nakauchi, Kazuki Inaba, Yoshinori Ishida, Ichiro Uyama
Koichi Suda, Masaya Nakauchi, Kazuki Inaba, Yoshinori Ishida, Ichiro Uyama, Division of Upper GI, Department of Surgery, Fujita Health University, Kutsukake, Toyoake, Aichi 470-1192, Japan
Author contributions: All the authors have fully met the ICMJE authorship criteria. In detail, Suda K, Inaba K, Ishida Y, and Uyama I designed the research; Suda K, and Nakauchi M conducted the research in combination with analyses of the data; all the authors contributed to interpretation of the data; Suda K wrote the paper.
Conflict-of-interest statement: Suda K and Uyama I are funded by Intuitive Surgical, Inc. in relation to a multi-institutional single-arm prospective study, which Japanese Ministry of Health, Labor, and Welfare has recently approved for Advanced Medical Technology (“Clinical advantage of robotic radical gastrectomy for gastric cancer: multi-institutional prospective cohort study”, INTUITIVE SURGICAL OPERATIONS, INC. 2015 CLINICAL ROBOTIC RESEARCH GRANT, $50000). Nakauchi M, Inaba K and Ishida Y have no commercial association with or financial involvement that might pose a conflict of interest in connection with the submitted article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Koichi Suda, MD, PhD, FACS, Division of Upper GI, Department of Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi 470-1192, Japan. ko-suda@nifty.com
Telephone: +81-562-939254 Fax: +81-562-939011
Received: March 2, 2016
Peer-review started: March 4, 2016
First decision: April 1, 2016
Revised: April 3, 2016
Accepted: April 20, 2016
Article in press: April 20, 2016
Published online: May 21, 2016
Abstract

Minimally invasive surgery (MIS) for upper gastrointestinal (GI) cancer, characterized by minimal access, has been increasingly performed worldwide. It not only results in better cosmetic outcomes, but also reduces intraoperative blood loss and postoperative pain, leading to faster recovery; however, endoscopically enhanced anatomy and improved hemostasis via positive intracorporeal pressure generated by CO2 insufflation have not contributed to reduction in early postoperative complications or improvement in long-term outcomes. Since 1995, we have been actively using MIS for operable patients with resectable upper GI cancer and have developed stable and robust methodology in conducting totally laparoscopic gastrectomy for advanced gastric cancer and prone thoracoscopic esophagectomy for esophageal cancer using novel technology including da Vinci Surgical System (DVSS). We have recently demonstrated that use of DVSS might reduce postoperative local complications including pancreatic fistula after gastrectomy and recurrent laryngeal nerve palsy after esophagectomy. In this article, we present the current status and future perspectives on MIS for gastric and esophageal cancer based on our experience and a review of the literature.

Keywords: Stomach neoplasms, Esophageal neoplasms, Minimally invasive surgical procedures, Postoperative complications, Robotic surgical procedures

Core tip: Minimally invasive surgery (MIS) for upper gastrointestinal cancer reduces intraoperative blood loss and postoperative pain, leading to faster recovery. It also results in better cosmetic outcomes. The impact of MIS on postoperative complications and long-term outcomes has been under debate. We have recently demonstrated that use of da Vinci Surgical System might reduce postoperative local complications including pancreatic fistula after gastrectomy and recurrent laryngeal nerve palsy after esophagectomy.