Robotic Esophagectomy for Esophageal Gastrointestinal Stromal Tumor
Matheus Sarmento Militz, MD, Alessandro Bersch Osvaldt, PhD, Diego da Fonseca Mossmann, MsC, Guilherme Goncalves Pretto, MsC, Mariana Sarmento Militz, MD, Oly Campos Corleta, PhD, Leandro Totti Cavazzola, PhD
Service of General Surgery, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil. Rua Ramiro Barcelos, 2350 – Santa Cecilia, Porto Alegre – RS, 90035-007 (Drs Militz, Corleta, Cavazzola and Messrs Mossman and Pretto).
Service of Digestive Surgery, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil. Rua Ramiro Barcelos, 2350 – Santa Cecilia, Porto Alegre – RS, 90035-007 (Dr Osvaldt).
Universidade do Sul de Santa Catarina, Palhoça, Santa Catarina, Brazil. Avenida Pedra Branca, 25 – Pedra Branca, Palhoça – SC, 88137-270 (Dr Militz).
Gastrointestinal stromal tumors (GST) account for less than 1% of the total tumors of the gastrointestinal tract. Data suggests that 50–60% of these tumors are located within the stomach and 10–20% in the small bowel. The esophagus involvement is extremely rare, accounting for less than 5% of all GST. This explains the scarcity of clinicopathological data and lack of clear recommendations regarding surgical management of this disease. Surgery as the first line therapy has been associated with better outcomes such as disease control, increased survival, and complete cure.
We present a case of a 63-year-old woman who was referred to the General Surgery Department of the Hospital de Clínicas de Porto Alegre due to dysphagia for solid food with 5years of evolution. Upper gastrointestinal endoscopy revealed an ulcerated and stenosing lesion of the middle third of the esophagus extending from 25 cm to 33 cm from the upper dental arch. Lesion biopsies confirmed the diagnosis of esophageal GST. She was submitted to neoadjuvance with tyrosine kinase inhibitor and a robotic esophagectomy in prone position was performed.
Key Words: Esophagus; Gastrointestinal stromal tumors; Esophagectomy; Robotic esophagectomy.