Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2024; 12(22): 4924-4931
Published online Aug 6, 2024. doi: 10.12998/wjcc.v12.i22.4924
Efficacy and prognostic analysis of carbon nanotracers combined with the da Vinci robot in the treatment of esophageal cancer
Fen-Qiang Qi, Yan Sun
Fen-Qiang Qi, Yan Sun, Cardiothoracic Surgery, The fourth affiliated hospital of Guangxi medical university/Liuzhou workers hospital, Liuzhou 545005, Guangxi Zhuang Autonomous Region, China
Author contributions: Qi FQ wrote the paper; Qi FQ and Sun Y designed the research, performed the research, and analyzed the data; All authors made substantial intellectual contributions to this paper.
Supported by Guangxi Health Department Scientific Research Program, No. Z20200206; and Project of Guangxi Liuzhou Science and Technology Bureau, No. 2024YB0101B010.
Institutional review board statement: This experiment was conducted according to the Declaration of Helsinki and was approved by the Research Ethics Committee of Liuzhou worker's Hospital.
Informed consent statement: Patients were not required to give informed consent for the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: The data supporting this article will be shared upon reasonable request to the corresponding author.
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: Yan Sun, MSci, Researcher, Instructor, Research Department, The Fourth Affiliated Hospital of Guangxi Medical University/Liuzhou worker's Hospital, No. 156 Heping Road, Liunan District, Liuzhou 545005, Guangxi Zhuang Autonomous Region, China. qifenqiang@163.com
Received: March 7, 2024
Revised: May 13, 2024
Accepted: June 3, 2024
Published online: August 6, 2024
Processing time: 117 Days and 0.6 Hours
Abstract
BACKGROUND

Traditional methods cannot clearly visualize esophageal cancer (EC) tumor contours and metastases, which limits the clinical application of da Vinci robot-assisted surgery.

AIM

To investigate the efficacy of the da Vinci robot in combination with nanocarbon lymph node tracers in radical surgery of EC.

METHODS

In total, 104 patients with early-stage EC who were admitted to Liuzhou worker's Hospital from January 2020 to June 2023 were enrolled. The patients were assigned to an observation group (n = 52), which underwent da Vinci robot-assisted minimally invasive esophagectomy (RAMIE) with the intraoperative use of nanocarbon tracers, and a control group (n = 52), which underwent traditional surgery treatment. The operation time, intraoperative blood loss, postoperative drainage tube indwelling time, hospital stay, number of lymph nodes dissected, incidence of complications, and long-term curative effects were comparatively analyzed. The postoperative stress response C-reactive protein (CRP), cortisol, epinephrine (E) and inflammatory response interleukin (IL)-6, IL-8, IL-10, and tumor necrosis factor-alpha (TNF-α) were evaluated.

RESULTS

Compared with the control group, the observation group had significantly lower postoperative CRP, cortisol, and E levels (P < 0.05) with a milder inflammatory response, as indicated by lower IL-6, IL-10, and TNF-α levels (P < 0.05). Patients who underwent RAMIE had less intraoperative blood loss and shorter operation times and hospital stays than those who underwent traditional surgery. The average number of dissected lymph nodes, time of lymph node dissection, and mean smallest lymph node diameter were all significantly lower in the observation group (P < 0.05). The rate of postoperative complications was 5.77% in the observation group, significantly lower than the 15.38% observed in the control group. Furthermore, the lymphatic metastasis rate, reoperation rate, and 12- and 24-month cumulative mortality in the observation group were 1.92%, 0%, 0%, and 0%, respectively, all of which were significantly lower than those in the control group (P < 0.05).

CONCLUSION

The treatment of EC using the da Vinci robot combined with nanocarbon lymph node tracers can achieve good surgical outcomes and demonstrates promising clinical applications.

Keywords: Nanocarbon tracer, Da Vinci robot, Minimally invasive esophagectomy, Esophageal cancer, Clinical efficacy, Prognostic

Core Tip: Traditional surgical visualization for esophageal cancer (EC) cannot clearly delineate tumor contours and metastases, which limits the accuracy of da Vinci robotic surgery. However, few studies have investigated the effect of nanocarbon tracers combined with da Vinci robotic surgery. This study clarified the therapeutic efficacy of the da Vinci robot system combined with the nanocarbon lymph node tracer in the treatment of patients with EC and confirmed the promising clinical applications thereof.