Outcomes of robotic esophagectomies for esophageal cancer by hospital volume: an analysis of the national cancer database

Hue, Jonathan J.; Bachman, Katelynn C.; Worrell, Stephanie G.; Gray, Kelsey; Linden, Philip A.; Towe, Christopher W.

doi:10.1007/s00464-020-07875-z

Cited by 12 publications

(3 citation statements)

References 25 publications

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“…Robot-assisted resection of esophageal cancer has been increasingly carried out in several large international reference centers. [21][22][23] The excellent minimally invasive effect 7,16,17 and higher efficiency of regional lymph node dissection 12,24 have been demonstrated. Even so, conventional MIE is currently the mainstream technique in esophageal cancer surgery, especially in Asia where the usage rate has reached about 80%.…”

Section: Discussionmentioning

confidence: 98%

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Robot-assisted Versus Conventional Minimally Invasive Esophagectomy for Resectable Esophageal Squamous Cell Carcinoma

Yang

et al. 2021

Annals of Surgery

103

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Objective:To compare perioperative and long-term outcomes of robot-assisted minimally invasive esophagectomy (RAMIE) and conventional minimally invasive esophagectomy (MIE) in the treatment for patients with esophageal squamous cell carcinoma (ESCC).Summary Background Data:RAMIE has emerged as an alternative to traditional open or thoracoscopic approaches. Efficacy and safety of RAMIE and MIE in the surgical treatment for ESCC remains uncertain given the lack of high-level clinical evidence.Methods:The RAMIE trial was designed as a prospective, multicenter, randomized, controlled clinical trial that compares the efficacy and safety of RAMIE and MIE in the treatment of resectable ESCC. From August 2017 to December 2019, eligible patients were randomly assigned to receive either RAMIE or MIE performed by experienced thoracic surgeons from 6 high-volume centers in China. Intent-to-treat analysis was performed.Results:Significantly shorter operation time was taken in RAMIE (203.8 vs 244.9 min, P<0.001). Compared with MIE, RAMIE showed improved efficiency of thoracic lymph node dissection in patients who received neoadjuvant therapy (15 vs 12, P = 0.016), as well as higher achievement rate of lymph node dissection along the left recurrent laryngeal nerve (79.5% vs 67.6%, P = 0.001). No difference was found in blood loss, conversion rate, and R0 resection. The 90-day mortality was 0.6% in each group. Overall complications were similar in RAMIE (48.6%) compared with MIE (41.8%) (RR, 1.16; 95% CI, 0.92–1.46; P = 0.196). Besides, the rate of major complications (Clavien-Dindo classification ≥ III) was also comparable (12.2% vs 10.2%, P = 0.551). RAMIE showed similar incidences of pulmonary complications (13.8% vs 14.7%; P = 0.812), anastomotic leakage (12.2% vs 11.3%; P = 0.801), and vocal cord paralysis (32.6% vs 27.1%, P = 0.258) to MIE.Conclusions:Early results demonstrate that both RAMIE and MIE are safe and feasible for the treatment of ESCC. RAMIE can achieve shorter operative duration and better lymph node dissection in patients who received neoadjuvant therapy. Long-term results are pending for further follow-up investigations.Trial Registration:ClinicalTrial.gov Identifier: NCT03094351.

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Section: Discussionmentioning

confidence: 98%

“…Robot-assisted resection of esophageal cancer has been increasingly carried out in several large international reference centers 21–23 . The excellent minimally invasive effect 7,16,17 and higher efficiency of regional lymph node dissection 12,24 have been demonstrated.…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted Versus Conventional Minimally Invasive Esophagectomy for Resectable Esophageal Squamous Cell Carcinoma

Yang

et al. 2021

Annals of Surgery

103

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“…Several limitations to robotic-assisted esophagectomy should be noted, however, including the steep surgeon learning curve, risk of conversion to open, and requisite hospital cost and maintenance, but the benefits in outcomes and potential to advance the field by quantifying optimal surgical technique are certainly worth the investment for surgeons and institutions committed to advancing the field (25,51).…”

Section: Advantages In Robotic-assisted Esophagectomymentioning

confidence: 99%

Intraoperative fluorescence imaging in esophagectomy and its application to the robotic platform: a narrative review

Papageorge¹,

Sachdeva²,

Schumacher³

2022

J Thorac Dis

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Background and Objective: Robotic-assisted esophagectomy is an approach to minimally invasive esophagectomy (MIE) that has demonstrated equivalent or improved outcomes relative to open and other minimally invasive techniques. The robotic approach also allows unique opportunities to improve complications following esophagectomy through use of enhanced visualization tools, including intraoperative fluorescence imaging. In this review, we summarize the specific uses of intraoperative fluorescence imaging as an adjunct tool during esophagectomy and discuss its application to the robotic platform.

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Long-term survival outcomes associated with robotic-assisted minimally invasive esophagectomy (RAMIE) for esophageal cancer

2022

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Outcomes of robotic esophagectomies for esophageal cancer by hospital volume: an analysis of the national cancer database

Cited by 12 publications

References 25 publications

Robot-assisted Versus Conventional Minimally Invasive Esophagectomy for Resectable Esophageal Squamous Cell Carcinoma

Robot-assisted Versus Conventional Minimally Invasive Esophagectomy for Resectable Esophageal Squamous Cell Carcinoma

Intraoperative fluorescence imaging in esophagectomy and its application to the robotic platform: a narrative review

Long-term survival outcomes associated with robotic-assisted minimally invasive esophagectomy (RAMIE) for esophageal cancer

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