Early Outcomes of Robot-Assisted Versus Thoracoscopic-Assisted Ivor Lewis Esophagectomy for Esophageal Cancer: A Propensity Score-Matched Study

Zhang, Yajie; Han, Yu; Gan, Qinyi; Xiang, Jie; Jin, Runsen; Chen, Kai; Che, Jiaming; Hang, Junjie; Li, Hecheng

doi:10.1245/s10434-019-07273-3

Cited by 68 publications

(106 citation statements)

References 36 publications

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“…Since the amount of significantly measurable improvements by robotic assistance compared with conventional MIE is expected to be rather small, high numbers of patients need to be treated for a trial to compare both procedures. The results of the abovementioned trials (e.g., the REVATE study and ROBOT-2 trial [42]) which compare RAMIE with conventional MIE are eagerly awaited [43,44].…”

Section: Ramie-development and Clinical Evidence Of Robot Assisted Esmentioning

confidence: 99%

Minimally invasive esophagectomy: clinical evidence and surgical techniques

Mann

Berlth

Hadzijusufoviç

et al. 2020

Langenbecks Arch Surg

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Background Surgical esophagectomy plays a crucial role in the curative and palliative treatment of esophageal cancer. Thereby, minimally invasive esophagectomy (MIE) is increasingly applied all over the world. Combining minimal invasiveness with improved possibilities for meticulous dissection, robot-assisted minimal invasive esophagectomy (RAMIE) has been implemented in many centers. Purpose This review focuses on the development of MIE as well as RAMIE and their value based on evidence in current literature. Conclusion Although MIE and RAMIE are highly complex procedures, they can be performed safely with improved postoperative outcome and equal oncological results compared with open esophagectomy (OE). RAMIE offers additional advantages regarding surgical dissection, lymphadenectomy, and extended indications for advanced tumors.

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Section: Ramie-development and Clinical Evidence Of Robot Assisted Esmentioning

confidence: 99%

Minimally invasive esophagectomy: clinical evidence and surgical techniques

Mann

Berlth

Hadzijusufoviç

et al. 2020

Langenbecks Arch Surg

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“…The ROBOT trial showed that a mean of 27 and 25 lymph nodes were harvested in RAMIE and OE, respectively (not significantly different) [31] , which demonstrated that robotic surgery is at least comparable to open surgery for retrieving a sufficient number of lymph nodes. Although most early studies have found that the lymph node yield with RAMIE and MIE are similar [39][40][41] , in two recent series in which RAMIE and MIE were applied to upper mediastinal LND, markedly larger numbers of lymph nodes were harvested with RAMIE (median 37-49 vs. 19-21) [42,43] . In addition, when Motoyama et al [44] compared the number of lymph nodes dissected from around the left RLN, they found that significantly more lymph nodes were dissected with RAMIE than MIE (median 6 vs. 4).…”

Section: Lymph Node Dissection In Ramiementioning

confidence: 91%

Trends in the evolution to robot-assisted minimally invasive thoracoscopic esophagectomy

Li¹,

Motoyama²,

Sato³

et al. 2020

Mini-invasive Surg

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Much effort has been made to improve outcomes and/or minimize the invasiveness of esophagectomy for thoracic esophageal cancer. This has led to the evolution from open esophagectomy to thoracoscopic minimally invasive esophagectomy (MIE), and from MIE to robot-assisted minimally invasive esophagectomy (RAMIE). RAMIE is being applied clinically to overcome the limitations of MIE. In this article, we review the trends in the evolution from thoracoscopic MIE to RAMIE. It has now been demonstrated that RAMIE is both safe and feasible, and may decrease morbidity and mortality rates associated with esophagectomy and improve oncological outcomes. On the other hand, there are still many problems that need to be solved.

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“…At our center, a robotic surgical system installed in 2016 has been used for esophagectomy and radical LND for ESCC. In recent years, some studies have compared robot-and video-assisted MIE [13,14] with open surgery [15,16]. The results confirmed that robot-assisted MIE can obtain better mediastinal LND and RLN protection [17,18].…”

mentioning

confidence: 82%

Lymph node dissection around left recurrent laryngeal nerve: robot-assisted vs. video-assisted McKeown esophagectomy for esophageal squamous cell carcinoma

et al. 2020

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Objective This study investigated the advantages of robot-assisted McKeown esophagectomy (RAME) for extensive superior mediastinal lymph node dissection (LND) versus video-assisted McKeown esophagectomy (VAME). Methods The cases of 184 consecutive esophageal squamous cell carcinoma (ESCC) patients who underwent minimally invasive McKeown esophagectomy (109 with RAME, 75 with VAME) performed by a single surgical group between June 2017 and December 2019 were retrospectively reviewed. Results Overall, 59.8% (110/181) patients (70 treated with RAME, 40 treated with VAME; 64.2% vs. 53.3%, respectively, p = 0.139) underwent complete LND around the left recurrent laryngeal nerve (RLN) by pathological assessment. Cumulative sum plots showed increased numbers of LND around the left RLN (3.6 ± 2.0 vs. 5.4 ± 2.7, p = 0.008) and a decreased incidence of recurrent nerve injury (27.9% vs. 7.4%, p = 0.037) after RAME learning curve. Despite similar overall LND results (30.6 ± 10.2 vs. 28.1 ± 10.2, p > 0.05), RAME yielded more LND (5.4 ± 2.7 vs. 4.4 ± 2.2, p = 0.016) and a greater proportion of lymph node metastases (37.0% vs. 7.5%) around the left RLN but induced a lower proportion of recurrent nerve injuries (7.4% vs. 22.5%, p = 0.178) compared with VAME. Further analysis revealed that the complete LND around the left RLN was associated with recurrent nerve injury in the RAME (20.0% vs. 5.1%, p = 0.035) and VAME (22.5% vs. 5.7%, p = 0.041) groups but did not affect other clinical outcomes including surgical duration, intraoperative blood loss, postoperative intensive care unit stay, hospital stay, and other complications. Conclusions For patients with ESCC, RAME has great advantages in LND around the left RLN and recurrent nerve protection after learning curve of robotic esophagectomy.

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Early Outcomes of Robot-Assisted Versus Thoracoscopic-Assisted Ivor Lewis Esophagectomy for Esophageal Cancer: A Propensity Score-Matched Study

Cited by 68 publications

References 36 publications

Minimally invasive esophagectomy: clinical evidence and surgical techniques

Minimally invasive esophagectomy: clinical evidence and surgical techniques

Trends in the evolution to robot-assisted minimally invasive thoracoscopic esophagectomy

Lymph node dissection around left recurrent laryngeal nerve: robot-assisted vs. video-assisted McKeown esophagectomy for esophageal squamous cell carcinoma

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