A Case of a High-risk Obese Patient with Esophageal Cancer who Underwent the Two-stage Robot-assisted Surgery

Abstract

A 53-year-old man presented with vagueness and was diagnosed with Barrett's esophagus and Barrett's adenocarcinoma by an upper gastrointestinal endoscopy. After close examination, he was clinically diagnosed as having Barrett's adenocarcinoma, AeLt, cT1b, cN0, cM0, cStage I. No lymph node and distant metastases were seen. We planned a two-stage operation because of his risk factors including obesity (BMI 34), chronic renal failure (Cre 3.98 mg/dl, eGFR 14 ml/min) and type 2 diabetes (HbA1c 6.9%). The first-stage operation was consisted of robot-assisted subtotal esophagectomy, gastrostomy, and cervical esophagostomy. One month after the first-stage operation, a robot-assisted gastric tube creation, and reconstruction via the retrosternal route with cervical anastomosis and enterostomy were performed as the second-stage operation. We drained anastomotic leakage, and then he was discharged from the hospital on the 30th postoperative day. We report a case of a high-risk obese patient with esophageal cancer who was safely operated on by using the two-stage robot-assisted surgery.