Early diagnostic endoscopy and prophylactic stenting after robotic transthoracic esophagectomy - From skepticism to standardization

Abstract

Dehiscence following esophagectomy for cancer has a mortality rate of 10-40%, prolongs hospital stay, and reduces survival. To prevent it, proper patient selection and surgical techniques that minimize tension and ischemia are essential. Procedures such as ERAS protocols and the use of indocyanine green have improved the detection of well-vascularized areas, but the leak rate still exceeds 10%. In a series of 12 patients who underwent robotic esophagectomy, 45.4% received a prophylactic stent. These patients had a mean hospital stay of 16 days, compared to 53.5 days for those who experienced dehiscence. Early endoscopy and the placement of a prophylactic stent proved to be safe and effective in reducing complications.