Outcomes of robotic versus non-robotic minimally-invasive esophagectomy for esophageal cancer: An American College of Surgeons NSQIP database analysis

Harbison, Gregory J.; Vossler, John D.; Yim, Nicholas H.; Murayama, Kenric M.

doi:10.1016/j.amjsurg.2019.08.007

Cited by 32 publications

(42 citation statements)

References 31 publications

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“…None of these studies showed significant difference in the incidence rate of postoperative pneumonia. However, two studies which included 100 or more cases undergoing RAMIE reported a relatively lower rate of postoperative pneumonia 51,52 . On the other hand, no consistent trend was found regarding another important life‐threatening complication of anastomotic leak.…”

Section: Comparison Of Short‐term Outcomes Between Ramie and Miementioning

confidence: 97%

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Robot‐assisted minimally invasive esophagectomy for esophageal cancer: Meticulous surgery minimizing postoperative complications

Hosoda

Harada

Yamashita

et al. 2020

Annals of Gastroent Surgery

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Minimally invasive esophagectomy (MIE) has been reported to reduce postoperative complications especially pulmonary complications and have equivalent long‐term survival outcomes as compared to open esophagectomy. Robot‐assisted minimally invasive esophagectomy (RAMIE) using da Vinci surgical system (Intuitive Surgical, Sunnyvale, USA) is rapidly gaining attention because it helps surgeons to perform meticulous surgical procedures. McKeown RAMIE has been preferably performed in East Asia where squamous cell carcinoma which lies in more proximal esophagus than adenocarcinoma is a predominant histological type of esophageal cancer. On the other hand, Ivor Lewis RAMIE has been preferably performed in the Western countries where adenocarcinoma including Barrett esophageal cancer is the most frequent histology. Average rates of postoperative complications have been reported to be lower in Ivor Lewis RAMIE than those in McKeown RAMIE. Ivor Lewis RAMIE may get more attention for thoracic esophageal cancer. The studies comparing RAMIE and MIE where recurrent nerve lymphadenectomy was thoroughly performed reported that the rate of recurrent nerve injury is lower in RAMIE than in MIE. Recurrent nerve injury leads to serious complications such as aspiration pneumonia. It seems highly probable that RAMIE is beneficial in performing recurrent nerve lymphadenectomy. Surgery for esophageal cancer will probably be more centralized in hospitals with surgical robots, which enable accurate lymph node dissection with less complications, leading to improved outcomes for patients with esophageal cancer. RAMIE might occupy an important position in surgery for esophageal cancer.

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Section: Comparison Of Short‐term Outcomes Between Ramie and Miementioning

confidence: 97%

“…Table 3 shows 12 retrospective studies comparing short-term outcomes of RAMIE and MIE. 14,[50][51][52][53][54][55][56][57][58][59][60] In seven of these studies, propensity score matching was conducted to balance confounding factors to reduce possible bias.…”

Section: Comparison Of S Hort-term Outcome S B E T Ween R Amie and Miementioning

confidence: 99%

Robot‐assisted minimally invasive esophagectomy for esophageal cancer: Meticulous surgery minimizing postoperative complications

Hosoda

Harada

Yamashita

et al. 2020

Annals of Gastroent Surgery

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“…Retrospective database studies have also been performed comparing MIE and RAMIE. Harbison and colleagues used the American College of Surgeons NSQIP database to compare the two approaches (31). In an analysis of 725 cases (100 RAMIE vs. 625 MIE), there were no differences in short term postoperative adverse outcomes.…”

Section: Discussionmentioning

confidence: 99%

Robotic assisted minimally invasive esophagectomy: Ivor-Lewis approach

Musgrove¹,

Spear²,

Kakuturu³

et al. 2021

Shanghai Chest

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Recent published data indicate robotic assisted minimally invasive esophagectomy (RAMIE) can achieve comparable, if not superior outcomes to minimally invasive esophagectomy (MIE). Several studies have demonstrated improved postoperative pain and decreased cardiopulmonary complications following RAMIE for resectable intrathoracic esophageal cancer compared to MIE. Superior three-dimensional visualization and increased instrument precision result in greater lymph node harvest and ensures R0resection without an increase in intraoperative complications or anastomotic leaks. Herein the authors describe their recent adoption of RAMIE as the standard of care over MIE for patients with resectable esophageal cancer. The authors present a detailed approach to preoperative considerations, intraoperative technical nuances and technique and postoperative outcomes and follow-up following RAMIE. An up to date review of the literature is presented and congruently acknowledges RAMIE as a feasible and safe alternative to MIE with comparable oncologic outcomes.

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“…One study was a RCT [14] , and the other 13 were observational studies including one prospective [31] and 12 retrospective studies published from 2009 to 2019. In addition, four papers had propensity-matched analysis [22,28,29,39] and three were multi-center studies [16,17,39] .…”

Section: Literature Searchmentioning

confidence: 99%

“…From the innovative and pioneering experiences of Giulianotti et al [12] and Kernstine et al [13] , RAMIE has gained popularity amongst surgeons because it seems to ensure adequate oncological outcomes with lower surgical trauma, and fewer post-operative complications in a stable and comfortable environment [14] . A recent randomized controlled trial (RCT) [14] , a meta-analysis [15] and some multicenter retrospective studies [16,17] have demonstrated the safety and oncological adequacy of RAMIE, but other well-designed comparative long-term studies are needed to validate and establish the role of RAMIE.…”

Section: Introductionmentioning

confidence: 99%

Robot-assisted minimally invasive esophagectomy: systematic review on surgical and oncological outcomes

Bongiolatti¹,

Farronato²,

Marino³

et al. 2020

Mini-invasive Surg

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Aim: Esophagectomy is associated with several post-operative complications (50%-70%) due to surgical trauma. Minimally invasive techniques have therefore been applied to decrease mortality and morbidity. Robotassisted minimally-invasive esophagectomy (RAMIE) was developed to overcome the drawbacks of the thoracolaparoscopic approach. The objective of this systematic review is to report some recent experiences and to compare RAMIE with other approaches to esophagectomy, focusing on technical and oncological aspects.Methods: Pubmed, Embase and Scopus databases were searched for "robot-assisted esophagectomy", "minimally invasive esophagectomy" and "robotic esophagectomy" in January 2020. The study was focused on original papers on totally endoscopic RAMIE in the English language. No statistical procedures (meta-analysis) were performed.Results: Three hundred and twenty studies were identified across the database and after screening and reviewing, 14 were included for final analysis. The overall 90-day post-operative mortality after trans-thoracic esophagectomy ranged from 0% to 9% and did not differ between approaches. Post-operative complications ranged between 24% and 60.9%: respiratory (6.25% to 65%), cardiac (0.8% to 32%), anastomotic leak (3.1% and 37.5%) and vocal cord palsy (9.1%-35%) were the most frequent. The evidence for long-term outcomes is weak, with no significant differences in overall survival, disease-free survival and recurrence identified in comparison with other approaches. The selected papers showed that RAMIE had comparable outcomes between the open and thoraco-laparoscopic approaches within a multimodal treatment pathway. Conclusion:RAMIE also seems to be associated with better lymph node dissection, nerve sparing and quality of life, but larger studies are needed to obtain more evidence.

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Outcomes of robotic versus non-robotic minimally-invasive esophagectomy for esophageal cancer: An American College of Surgeons NSQIP database analysis

Cited by 32 publications

References 31 publications

Robot‐assisted minimally invasive esophagectomy for esophageal cancer: Meticulous surgery minimizing postoperative complications

Robot‐assisted minimally invasive esophagectomy for esophageal cancer: Meticulous surgery minimizing postoperative complications

Robotic assisted minimally invasive esophagectomy: Ivor-Lewis approach

Robot-assisted minimally invasive esophagectomy: systematic review on surgical and oncological outcomes

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