Lessons learnt from uncommon events during robotic assisted minimally invasive oesophagectomy

Authors

  • Suraj B. Pawar Department of Surgical Oncology Robotic Surgery, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India
  • Kiran G. Bagul Department of Surgical Oncology Robotic Surgery, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India
  • Rishikesh D. Nilapwar Department of Surgical Oncology, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India
  • Hitesha Bhandari Department of Pathology, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India
  • Aditya S. Pawar Department of Radiation Oncology, Pravara Rural Hospital, Loni, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20240764

Keywords:

Oesophagectomy, Air leak, Lung

Abstract

Esophagectomy is the mainstay treatment for cancer of the esophagus. Over the last two decades robotic assisted minimally invasive oesephagectomy (RAMIE) have become increasingly popular in esophageal surgery. We present a rare complication of an air leak following RAMIE. Our patient underwent a robotic assisted total esophageal mobilization, lymph node dissection transthoracically for a lower oesophageal tumour. He developed persistent air leak and needed oxygen support. Following which thoracoscopic bullectomy was done, lung was successfully re-inflated. To the authors’ knowledge, this rare complication has only handful cases reported in the medical literature; other surgeons should be made aware of this problem.

References

Esagian SM, Ziogas IA, Skarentzos K, Katsaros I, Tsoulfas G, Molena D, et al. Robot-Assisted Minimally Invasive Esophagectomy versus Open Esophagectomy for Esophageal Cancer: A Systematic Review and Meta-Analysis. Cancers (Basel). 2022;14(13):3177.

Bronstein ME, Koo DC, Weigel TL. Management of air leaks post-surgical lung resection. Ann Transl Med. 2019;7(15):361-7.

Dugan KC, Laxmanan B, Murgu S, Hogarth DK. Management of Persistent Air Leaks. Chest. 2017;152(2):417-23.

Aprile V, Bacchin D, Calabrò F, Korasidis S, Mastromarino MG, Ambrogi MC, et al. Intraoperative prevention and conservative management of postoperative prolonged air leak after lung resection: a systematic review. J Thorac Dis. 2023;15(2):878-92.

Edmondson J, Hunter J, Bakis G, O'Connor A, Wood S, Qureshi AP. Understanding Post-Esophagectomy Complications and Their Management: The Early Complications. J Clin Med. 2023;12(24):7622.

Kuwano H, Sumiyoshi K, Sonoda K, Kitamura K, Tsutsui S, Toh Y, et al. Relationship between preoperative assessment of organ function and postoperative morbidity in patients with oesophageal cancer. Eur J Surg. 1998;164:581-6.

Lodhia JV, Tenconi S. Postoperative subcutaneous emphysema: prevention and treatment. Shanghai Chest. 2021;5:17-24.

Kumar V, Agarwal A, Arnav R, Sharma R. Air Leak Conundrum following Oesophagectomy: A Case Report and Review of Literature. J Clin Diagnost Res. 2023;17(9):D01-2.

Marano A, Palagi S, Pellegrino L, Borghi F. Robotic Intraoperative Tracheobronchial Repair during Minimally Invasive 3-Stage Esophagectomy. J Chest Surg. 2021;54(2):154-7.

Saini N, Nar A, Jabbal HS, Mishra A, Bains MS. Video-Assisted Thoracoscopic Surgery (VATS) for Spontaneous Pneumothorax and Emphysematous Bullous Lung Disease: A Study From Northern India. Cureus. 2022;14(6):e25769.

Han KN, Kim HK, Lee HJ, Lee DK, Kim H, Lim SH, et al. Single-port thoracoscopic surgery for pneumothorax under two-lung ventilation with carbon dioxide insufflation. J Thorac Dis. 2016;8(6):1080-6.

Downloads

Published

2024-03-27

Issue

Section

Case Reports