上海交通大学医学院附属瑞金医院胸外科,上海 200025
Received:29 September 2025,
Revised:2025-10-17,
Accepted:17 November 2025,
Published:28 March 2026
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王希鹏,李成强,曹羽钦,等.机器人辅助手术在食管癌Ivor-Lewis手术中的应用现状与未来展望[J].重庆医科大学学报,2026,51(3):293-296.
Wang Xipeng,Li Chengqiang,Cao Yuqin,et al.Robot-assisted Ivor-Lewis esophagectomy in treatment of esophageal cancer:current status and future perspectives[J].Journal of Chongqing Medical University,2026,51(3):293-296.
王希鹏,李成强,曹羽钦,等.机器人辅助手术在食管癌Ivor-Lewis手术中的应用现状与未来展望[J].重庆医科大学学报,2026,51(3):293-296. DOI: 10.13406/j.cnki.cyxb.004018.
Wang Xipeng,Li Chengqiang,Cao Yuqin,et al.Robot-assisted Ivor-Lewis esophagectomy in treatment of esophageal cancer:current status and future perspectives[J].Journal of Chongqing Medical University,2026,51(3):293-296. DOI: 10.13406/j.cnki.cyxb.004018.
Ivor-Lewis手术是治疗胸腹段食管癌的经典术式,随着微创外科的快速发展,机器人辅助食管切除术(robot-assisted minimally invasive esophagectomy,RAMIE)逐渐成为胸外科领域的重要创新。机器人系统以其高清三维视野、灵活操作及高稳定性,弥补了传统胸腔镜手术(minimally invasive esophagectomy,MIE)在复杂解剖区域操作受限的不足,为胸内食管切除与食管-胃吻合提供了新技术路径。国内外多项研究显示,机器人辅助Ivor-Lewis食管切除术(robot-assisted Ivor-Lewis esophagectomy,RAILE)在淋巴结清扫的彻底性、胸内吻合的精确性以及术中并发症控制方面具有优势;但同时仍存在手术耗时长、学习曲线陡峭、费用高昂等问题。未来,随着机器人系统的迭代升级、人工智能与影像导航技术的融合,以及多中心循证医学证据的积累,RAILE有望在食管癌的外科治疗中发挥更为核心的作用。
The Ivor-Lewis procedure remains a classic surgical procedure in the treatment of thoracoabdominal esophageal cancer,and with the rapid development of minimally invasive surgery,robot-assisted minimally invasive esophagectomy has emerged as a significant innovation in thoracic surgery. Robotic systems provide high-definition three-dimensional visualization,enhanced dexterity,and superior stability,overcoming the limitations of conventional minimally invasive esophagectomy in complex anatomical regions and providing a new technical path for intrathoracic esophagectomy and esophagogastric anastomosis. Many studies in China and globally have shown that robot-assisted Ivor-Lewis esophagectomy offers advantages in thorough lymph node dissection,precise intrathoracic anastomosis,and effective control of intraoperative complications; nevertheless,there are still challenges such as a long time of operation,a steep learning curve,and high costs. In the future,with the continuous upgrades of robotic systems,the integration of artificial intelligence and image-guided navigation,and the accumulation of multicenter evidence-based medicine data,RAILE is expected to play an increasingly central role in the surgical treatment of esophageal cancer.
Bray F , Laversanne M , Sung H , et al . Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [J ] . CA Cancer J Clin , 2024 , 74 ( 3 ): 229 - 263 .
Zheng RS , Zhang SW , Zeng HM , et al . Cancer incidence and mortality in China,2016 [J ] . J Natl Cancer Cent , 2022 , 2 ( 1 ): 1 - 9 .
Hsu PK , Huang CS , Wu YC , et al . Open versus thoracoscopic esophagectomy in patients with esophageal squamous cell carcinoma [J ] . World J Surg , 2014 , 38 ( 2 ): 402 - 409 .
Biere SSAY , van Berge Henegouwen MI , Maas KW , et al . Minimally invasive versus open oesophagectomy for patients with oesophageal cancer:a multicentre,open-label,randomised controlled trial [J ] . Lancet , 2012 , 379 ( 9829 ): 1887 - 1892 .
van Workum F , Slaman AE , van Berge Henegouwen MI , et al . Propensity score-matched analysis comparing minimally invasive ivor lewis versus minimally invasive mckeown esophagectomy [J ] . Ann Surg , 2020 , 271 ( 1 ): 128 - 133 .
Junttila A , Helminen O , Helmiö M , et al . Five-year survival after McKeown compared to Ivor-Lewis esophagectomy for esophageal cancer: a population-based nationwide study in Finland [J ] . Ann Surg , 2023 , 277 ( 6 ): 964 - 970 .
Bizekis C , Kent MS , Luketich JD , et al . Initial experience with minimally invasive Ivor Lewis esophagectomy [J ] . Ann Thorac Surg , 2006 , 82 ( 2 ): 402 - 406 .
Claassen L , Hannink G , Luyer MDP , et al . Learning curves of ivor lewis totally minimally invasive esophagectomy by hospital and surgeon characteristics: a retrospective multinational cohort study [J ] . Ann Surg , 2022 , 275 ( 5 ): 911 - 918 .
van Workum F , Stenstra MHBC , Berkelmans GHK , et al . Learning curve and associated morbidity of minimally invasive esophagectomy:a retrospective multicenter study [J ] . Ann Surg , 2019 , 269 ( 1 ): 88 - 94 .
Giulianotti PC , Coratti A , Angelini M , et al . Robotics in general surgery:personal experience in a large community hospital [J ] . Arch Surg , 2003 , 138 ( 7 ): 777 - 784 .
Han Y , Zhang YJ , Zhang WT , et al . Learning curve for robot-assisted Ivor Lewis esophagectomy [J ] . Dis Esophagus , 2022 , 35 ( 2 ): doab026 .
Jin RS , Xiang J , Han DP , et al . Robot-assisted Ivor-Lewis esophagectomy with intrathoracic robot-sewn anastomosis [J ] . J Thorac Dis , 2017 , 9 ( 11 ): 990 - 993 .
Zhang Y , Xiang J , Han Y , et al . Initial experience of robot-assisted Ivor-Lewis esophagectomy:61 consecutive cases from a single Chinese institution [J ] . Dis Esophagus , 2018 , 31 ( 12 ): 10 .1093.
Zhang YJ , Han Y , Gan QY , et al . Early outcomes of robot-assisted versus thoracoscopic-assisted Ivor Lewis esophagectomy for esophageal cancer:a propensity score-matched study [J ] . Ann Surg Oncol , 2019 , 26 ( 5 ): 1284 - 1291 .
Wang XP , Lu T , Guo W , et al . The impact of surgical assistants on postoperative complications in robot-assisted Ivor-Lewis esophagectomy for esophageal carcinoma [J ] . Front Surg , 2024 , 11 : 1492651 .
Grimminger PP , van der Horst S , Ruurda JP , et al . Surgical robotics for esophageal cancer [J ] . Ann N Y Acad Sci , 2018 , 1434 ( 1 ): 21 - 26 .
Kanamori J , Watanabe M , Maruyama S , et al . Current status of robot-assisted minimally invasive esophagectomy:what is the real benefit? [J ] . Surg Today , 2022 , 52 ( 9 ): 1246 - 1253 .
van der Sluis PC , van der Horst S , May AM , et al . Robot-assisted minimally invasive thoracolaparoscopic esophagectomy versus open transthoracic esophagectomy for resectable esophageal cancer:a randomized controlled trial [J ] . Ann Surg , 2019 , 269 ( 4 ): 621 - 630 .
Manigrasso M , Vertaldi S , Marello A , et al . Robotic esophagectomy:a systematic review with meta-analysis of clinical outcomes [J ] . J Pers Med , 2021 , 11 ( 7 ): 640 .
尹钰恒 , 王雨雯 , 范 捷 , 等 . 基于可解释机器学习的肝硬化患者早期并发食管静脉曲张风险预测研究 [J ] . 重庆医科大学学报 , 2025 , 50 ( 3 ): 389 - 396 .
Yin YH , Wang YW , Fan J . Predicting the risk of early esophageal varices in patients with liver cirrhosis based on explainable machine learning [J ] . J Chongqing Med Univ , 2025 , 50 ( 3 ): 389 - 396 .
de Groot EM , van der Horst S , Kingma BF , et al . Robot-assisted minimally invasive thoracolaparoscopic esophagectomy versus open esophagectomy:long-term follow-up of a randomized clinical trial [J ] . Dis Esophagus , 2020 , 33 ( Suppl 2 ): doaa079 .
Hambright B , Wei B . Optimizing the technical results of robotic esophagectomy:conduit creation and esophagogastric anastomoses [J ] . Mini-invasive Surg , 2024 : 19 .
Melvin WS , Needleman BJ , Krause KR , et al . Computer-enhanced robotic telesurgery. Initial experience in foregut surgery [J ] . Surg Endosc , 2002 , 16 ( 12 ): 1790 - 1792 .
陈立如 , 李 斌 , 李春光 , 等 . 肺部手术后新发食管癌的治疗及预后分析 [J ] . 中华消化外科杂志 , 2025 , 24 ( 10 ): 1280 - 1289 .
Chen LR , Li B , Li CG , et al . Treatment and prognosis analysis of newly developed esophageal cancer after pulmonary surgery [J ] . Chin J Dig Surg , 2025 , 24 ( 10 ): 1280 - 1289 .
Kingma BF , Grimminger PP , van der Sluis PC , et al . Worldwide techniques and outcomes in robot-assisted minimally invasive esophagectomy(RAMIE):results from the multicenter international registry [J ] . Ann Surg , 2022 , 276 ( 5 ): 386 - 392 .
Meredith K , Blinn P , Maramara T , et al . Comparative outcomes of minimally invasive and robotic-assisted esophagectomy [J ] . Surg Endosc , 2020 , 34 ( 2 ): 814 - 820 .
Nora I , Shridhar R , Meredith K . Robotic-assisted Ivor Lewis esophagectomy: technique and early outcomes [J ] . Robot Surg , 2017 , 4 : 93 - 100 .
赵 越 , 张思洁 , 李海明 , 等 . 食管癌根治术后预后影响因素分析及机器学习预测模型的应用价值 [J ] . 中华消化外科杂志 , 2025 , 24 ( 10 ): 1305 - 1317 .
Zhao Y , Zhang SJ , Li HM , et al . Analysis of prognostic factors after radical resection of esophageal cancer and the application value of machine learning prediction models [J ] . Chin J Dig Surg , 2025 , 24 ( 10 ): 1305 - 1317 .
Hee L , Hyun P , Koo K . Robotic thoracic surgery using the single-port robotic system:initial experience with more than 100 cases [J ] . J Thorac Cardiovasc Surg , 2024 , 168 ( 6 ): 1513 - 1522 .
Li CQ , Chen X , Wang XP , et al . Single-port robotic-assisted approach in thoracic surgery:a prospective real-world study [J ] . Interdiscip Cardiovasc Thorac Surg , 2025 , 40 ( 7 ): ivaf161 .
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