Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Oct 15, 2023; 15(10): 1675-1690
Published online Oct 15, 2023. doi: 10.4251/wjgo.v15.i10.1675
Minimally invasive surgery for gastro-oesophageal junction adenocarcinoma: Current evidence and future perspectives
Rodica Bîrlă, Petre Hoara, Florin Achim, Valeriu Dinca, Diana Ciuc, Silviu Constantinoiu, Adrian Constantin
Rodica Bîrlă, Florin Achim, Silviu Constantinoiu, Adrian Constantin, Department of General Surgery, Carol Davila University, Bucharest 011172, Romania
Petre Hoara, Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest 020021, Romania
Valeriu Dinca, Diana Ciuc, Faculty of Medicine, “Titu Maiorescu” University, Bucharest 031593, Romania
Author contributions: Birla R and Constantin A designed the article framework; Birla R, Constantin A and Hoara P drafted the manuscript; Achim F, Dinca VG, Ciuc D, and Constantinoiu S critically revised the essential intellectual content of the manuscript; all authors have read and approved the final manuscript.
Conflict-of-interest statement: There is no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Petre Hoara, MD, PhD, Assistant Lecturer, Department of General Surgery, Carol Davila University of Medicine and Pharmacy, No. 37 Dionisie Lupu str, District 2, Bucharest 020021, Romania. petre.hoara@umfcd.ro
Received: July 5, 2023
Peer-review started: July 5, 2023
First decision: August 15, 2023
Revised: September 4, 2023
Accepted: September 22, 2023
Article in press: September 22, 2023
Published online: October 15, 2023
Abstract

Minimally invasive surgery is increasingly indicated in the management of malignant disease. Although oesophagectomy is a difficult operation, with a long learning curve, there is actually a shift towards the laparoscopic/thoracoscopic/ robotic approach, due to the advantages of visualization, surgeon comfort (robotic surgery) and the possibility of the whole team to see the operation as well as and the operating surgeon. Although currently there are still many controversial topics, about the surgical treatment of patients with gastro-oesophageal junction (GOJ) adenocarcinoma, such as the type of open or minimally invasive surgical approach, the type of oesophago-gastric resection, the type of lymph node dissection and others, the minimally invasive approach has proven to be a way to reduce postoperative complications of resection, especially by decreasing pulmonary complications. The implementation of new technologies allowed the widening of the range of indications for this type of surgical approach. The short-term and long-term results, as well as the benefits for the patient - reduced surgical trauma, quick and easy recovery - offer this type of surgical treatment the premises for future development. This article reviews the updates and perspectives on the minimally invasive approach for GOJ adenocarcinoma.

Keywords: Gastro-oesophageal adenocarcinoma, Minimally invasive oesophagectomy, Laparoscopic gastrectomy, Abdomino-mediastinal lymph node dissection, Indocyanine green fluorescence imaging

Core Tip: Minimally invasive surgery is increasingly indicated in the management of malignant disease. Although oesophagectomy is a difficult operation, with a long learning curve, there is actually a shift towards the laparoscopic/thoracoscopic/robotic approach, due to the advantages offered to the patient and surgeon. The short- term and long-term results, as well as the benefits for the patient – reduced surgical aggressiveness, quick and easy recovery, offer this type of surgical treatment the premises for future development. This article reviews the updates and perspectives on the minimally invasive approach for gastro-oesophageal junction adenocarcinoma.