Robot-assisted thoracoscopic esophagectomy versus thoracoscopic esophagectomy

Abstract

Background The gold standard for treating resectable esophageal cancer is esophagectomy. Robot-assisted thoracoscopic esophagectomy (RATE) is a technique that bridges the gap between open esophagectomy and minimally invasive surgery, although there is little evidence to support its superiority over traditional thoracoscopic esophagectomy (TE) in treating thoracic esophageal cancer. Method We included 159 patients who received TE and 35 patients who had RATE in this research after retrospectively analyzing clinical data from patients with esophageal cancer who underwent surgery at Qilu Hospital between August 2020 and August 2022. Both groups' intraoperative, postoperative, and preoperative patient characteristics were assessed. Results With regard to preoperative patient characteristics, all P values were greater than 0.05 in the TE and RATE groups except for height, and the preoperative characteristics of the two groups could be considered similar. In terms of intraoperative indices, there were no significant differences between the two groups in terms of TNM stage of resected tumor, tumor tissue type and ASA score. However, there were statistically significant differences between the TE and RATE groups in terms of operative time, intraoperative bleeding, total number of lymph nodes resected, and number of lymph nodes resected in the thoracoabdominal cavity. Regarding postoperative characteristics, there were statistically significant differences in pain scores on the first postoperative day and chest drainage on the first postoperative day, and there were no significant differences in the remaining characteristics between the two data groups. Conclusion This study confirmed the feasibility and safety of RATE for esophageal cancer by comparing it with TE. We concluded that RATE does result in more complete lymph node clearance, reduced operative time and surgical bleeding, and postoperative relief of patient pain and chest drainage. We plan to conduct the next clinical study with long-term follow-up to evaluate the tumor clearance, recurrence and survival rates after receiving RATE for esophageal cancer to investigate the role of RATE in esophageal cancer.