Abstract：
Robotic esophagectomy has improved early outcomes and enhanced the quality of lymphadenectomy for esophageal cancer surgery. This study aimed to determine risk factors for long-term survival following robotic esophagectomy and the causes of long-term mortality. We included patients who underwent robotic esophagectomy at our institute between 2010 and 2022. Robotic esophagectomy was defined as a surgical procedure performed robotically in both the abdomen and thorax. Robotic esophagectomy was performed in patients at all stages, including advanced stages, even in patients with stage IV and supraclavicular lymph node metastasis. A total of 340 patients underwent robotic esophagectomy during the study period. Ivor-Lewis operation and McKeown operation were performed on 153 (45.0%) and 187 (55.0%) patients, respectively. The five-year survival rates based on clinical stages were as follows: 85.2% in stage I, 62.0% in stage II, 54.5% in stage III, and 40.3% in stage IV. Risk factors for long-term survival included body mass index, Charlson comorbidity index, clinical stages, and postoperative complications of grade 4 or higher. Among the cases of long-term mortality, recurrence accounted for 42 patients (61.7%), while non-cancer-related death occurred in 26 patients (38.2%). The most common cause of non-cancer-related death was malnutrition and poor general condition, observed in 11 patients (16.2%). Robotic esophagectomy has demonstrated the ability to achieve acceptable long-term survival rates, even in patients with cervical lymph node metastasis. However, addressing high-grade postoperative complications and long-term malnutrition remains crucial for further improving the long-term survival outcomes of patients with esophageal cancer.
摘要：
机器人食管切除术改善了食管癌手术的早期结果并提高了淋巴结清扫术的质量。本研究旨在确定机器人食管切除术后长期生存的危险因素以及长期死亡的原因。我们纳入了2010年至2022年间在我们研究所接受机器人食管切除术的患者。机器人食管切除术被定义为在腹部和胸部均以机器人方式进行的外科手术。所有阶段的患者都进行了机器人食管切除术，包括高级阶段，即使是IV期和锁骨上淋巴结转移的患者。在研究期间，共有340名患者接受了机器人食管切除术。分别对153例(45.0%)和187例(55.0%)患者进行了Ivor-Lewis手术和McKeown手术,分别。基于临床分期的5年生存率如下：I期85.2%，第二阶段为62.0%，第三阶段为54.5%，第四阶段为40.3%。长期生存的危险因素包括体重指数，Charlson合并症指数,临床分期,术后并发症4级或以上。在长期死亡病例中，复发患者占42例（61.7%），而非癌症相关死亡发生在26例(38.2%).非癌症相关死亡的最常见原因是营养不良和不良的一般状况。在11例患者中观察到（16.2%）。机器人食管切除术已证明能够达到可接受的长期生存率，即使在有颈淋巴结转移的患者中。然而,解决高级别术后并发症和长期营养不良对于进一步改善食管癌患者的长期生存结局仍然至关重要.
