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Robot-assisted minimally invasive esophagectomy (RAMIE) compared to conventional minimally invasive esophagectomy (MIE) for esophageal cancer: a propensity-matched analysis.

Authors
  • Tagkalos, E1
  • Goense, L2
  • Hoppe-Lotichius, M1
  • Ruurda, J P2
  • Babic, B1
  • Hadzijusufovic, E1
  • Kneist, W1
  • van der Sluis, P C1
  • Lang, H1
  • van Hillegersberg, R2
  • Grimminger, P P1
  • 1 Department of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany. , (Germany)
  • 2 Department of Surgery, University Medical Center Utrecht, Utrecht, the Netherlands. , (Netherlands)
Type
Published Article
Journal
Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
Publication Date
Apr 15, 2020
Volume
33
Issue
4
Identifiers
DOI: 10.1093/dote/doz060
PMID: 31206577
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Robot-assisted minimally invasive esophagectomy (RAMIE) is increasingly being applied as treatment for esophageal cancer. In this study, the results of 50 RAMIE procedures were compared with 50 conventional minimally invasive esophagectomy (MIE) operations, which had been the standard treatment for esophageal cancer prior to the robotic era. Between April 2016 and March 2018, data of 100 consecutive patients with esophageal carcinoma undergoing modified Ivor Lewis esophagectomy were prospectively collected. All operations were performed by the same surgeon using an identical intrathoracic anastomotic reconstruction technique with the same perioperative management and pain control regimen. Intra-operative and postoperative complications were graded according to definitions stated by the Esophagectomy Complications Consensus Group. Data analysis was carried out with and without propensity score matching. Baseline characteristics did not show significant differences between the RAMIE and MIE group. Propensity score matching of the initial group of 100 patients resulted in two equal groups of 40 patients for each surgical approach. In the RAMIE group, the median total lymph node yield was 27 (range 13-84) compared to 23 in the MIE group (range 11-48), P = 0.053. Median intensive care unit (ICU) stay was 1 day (range 1-43) in the RAMIE group compared to 2 days (range 1-17) in the MIE group (P = 0.029). The incidence of postoperative complications was not significantly different between the two groups (P = 0.581). In this propensity-matched study comparing RAMIE to MIE, ICU stay was significantly shorter in the RAMIE group. There was a trend in improved lymphadenectomy in RAMIE. © The Author(s) 2019. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: [email protected]

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