Re-do robot-assisted salvage lobectomy after esophagectomy with gastric pull-up reconstruction: a case report.

IF 2.5 3区医学 Q3 ONCOLOGY

World Journal of Surgical Oncology Pub Date : 2025-04-08 DOI:10.1186/s12957-025-03661-0

Ghada Shahin, Rohit Kharbanda, Quirijn Tummers, Jerry Braun

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引用次数: 0

Abstract

Background: Robot-assisted Thoracic Surgery (RATS) is well-established for complex minimally invasive thoracic surgery. Despite the available literature, robotics for complex advanced NSCLC for re-do surgery remains underexplored.

Case presentation: We present a 55-year-old female who underwent esophagectomy with gastric pull-up reconstruction for squamous cell carcinoma (SCC) of the esophagus (cT3N2M0, stage IIIB) after neo-adjuvant concurrent chemoradiation therapy (ypT2N1 stage IIB disease). Six years later, computed tomography (CT) scan showed stage IA Thyroid Transcription Factor-1 (TTF-1) positive adenocarcinoma in the left upper lobe treated by stereotactic radiotherapy. Two years later, a SCC of the right upper lobe (RUL) was found (Fig. 1). Although locoregional therapy was preferred Pembrolizumab® was initiated with curative intent as the tumor demonstrated a high Programmed Death-Ligand 1 (PD-L1) expression. Follow-up CT-scan showed no biological response. Salvage lobectomy was proposed, and patient consent obtained. As demonstrated in the video, RATS provided great exposure to the adhesions, vascularization of the neo-oesophagus and maximal dexterity in difficult spaces.

Conclusions: This case demonstrates the value of RATS in complex re-do thoracic surgery after immunotherapy and previous thoracotomy.

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食管切除术后机器人辅助补救性肺叶切除术伴胃上拉重建1例报告。

背景：机器人辅助胸外科手术（RATS）在复杂的微创胸外科手术中得到了广泛的应用。尽管已有文献，但机器人技术在复杂晚期非小细胞肺癌再做手术中的应用仍未得到充分探索。病例介绍：我们报告了一名55岁的女性，她在新辅助同步放化疗（yptn1期IIB疾病）后接受食管鳞状细胞癌（cT3N2M0期，IIIB期）的食管切除术和胃上拉重建。6年后，计算机断层扫描（CT）显示左上叶甲状腺转录因子-1 （TTF-1）阳性腺癌，经立体定向放疗治疗。两年后，发现右上叶（RUL）的SCC（图1）。尽管首选局部治疗，但由于肿瘤表现出高程序性死亡配体1 （PD-L1）表达，Pembrolizumab®开始具有治愈意图。随访ct扫描未见生物学反应。提出保留性肺叶切除术，并获得患者同意。如视频所示，大鼠提供了大量的粘连，新食道血管化和最大的灵活性在困难的空间。结论：本病例证明了rat在免疫治疗和既往开胸手术后复杂的再行胸外科手术中的价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Surgical Oncology ONCOLOGY-SURGERY

CiteScore

4.70

自引率

15.60%

发文量

362

审稿时长

3 months

期刊介绍： World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.