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

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...

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Vydáno v:Diseases of the esophagus Ročník 33; číslo 4
Hlavní autoři: Tagkalos, E, Goense, L, Hoppe-Lotichius, M, Ruurda, J P, Babic, B, Hadzijusufovic, E, Kneist, W, van der Sluis, P C, Lang, H, van Hillegersberg, R, Grimminger, P P
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 15.04.2020
Témata:
Aged
Esophageal Neoplasms - surgery
Esophagectomy - adverse effects
Esophagectomy - methods
Female
Humans
Incidence
Lymph Node Excision - statistics & numerical data
Male
Middle Aged
Minimally Invasive Surgical Procedures - adverse effects
Minimally Invasive Surgical Procedures - methods
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Propensity Score
Prospective Studies
Robotic Surgical Procedures - adverse effects
Robotic Surgical Procedures - methods
Treatment Outcome
MIE
RAMIE
esophageal cancer
minimally invasive
Ivor Lewis
ISSN:1442-2050, 1442-2050
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Shrnutí: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.
Bibliografie:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
content type line 23
ISSN:1442-2050
1442-2050
DOI:10.1093/dote/doz060