Robotic-assisted minimally invasive oesophagectomy for cancer: An initial experience

Palanivelu, Chinnusamy; Dey, Sumanta; Sabnis, Sandeep C; Gupta, Raghavendra; Cumar, Bharath; Kumar, Saravana; Natarajan, Ramesh; Parthasarathi, Ramakrishnan

doi:10.4103/jmas.jmas_7_18

Cited by 2 publications

(2 citation statements)

References 22 publications

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“…Twenty studies reported total inpatient LoS of < 10 days; none of these studies used an open approach for the thoracic or abdominal phases. 25 , 41 , 43 , 44 , 52 , 56 – 69 In comparison, 27 studies reported total LoS > 14 days, of which six used an open approach in either the abdominal or thoracic phases. 5 , 24 , 25 , 33 , 42 , 45 , 46 , 55 , 70 – 85 This indicates the robotic and conventional minimally invasive approaches are associated with shorter LoS, however clinical trials are required to validate this.…”

Section: Discussionmentioning

confidence: 99%

“…In four studies, a stapled esophagogastric anastomosis was formed within the cervical wound to restore continuity of the digestive tract. 42 , 44 , 46 , 115 In comparison, two studies reported a hand-sewn anastomosis—one formed using the robotic platform and one extracorporeal. 42 , 115 The reported AL rate was higher among those who underwent three-stage esophagectomy (12.5%) compared with two-stage (8.10%).…”

Section: Discussionmentioning

confidence: 99%

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Is Robotic Surgery the Future for Resectable Esophageal Cancer?: A Systematic Literature Review of Oncological and Clinical Outcomes

Patel,

Yeung

et al. 2024

Ann Surg Oncol

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Background Radical esophagectomy for resectable esophageal cancer is a major surgical intervention, associated with considerable postoperative morbidity. The introduction of robotic surgical platforms in esophagectomy may enhance advantages of minimally invasive surgery enabled by laparoscopy and thoracoscopy, including reduced postoperative pain and pulmonary complications. This systematic review aims to assess the clinical and oncological benefits of robot-assisted esophagectomy. Methods A systematic literature search of the MEDLINE (PubMed), Embase and Cochrane databases was performed for studies published up to 1 August 2023. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocols and was registered in the PROSPERO database (CRD42022370983). Clinical and oncological outcomes data were extracted following full-text review of eligible studies. Results A total of 113 studies (n = 14,701 patients, n = 2455 female) were included. The majority of the studies were retrospective in nature (n = 89, 79%), and cohort studies were the most common type of study design (n = 88, 79%). The median number of patients per study was 54. Sixty-three studies reported using a robotic surgical platform for both the abdominal and thoracic phases of the procedure. The weighted mean incidence of postoperative pneumonia was 11%, anastomotic leak 10%, total length of hospitalisation 15.2 days, and a resection margin clear of the tumour was achieved in 95% of cases. Conclusions There are numerous reported advantages of robot-assisted surgery for resectable esophageal cancer. A correlation between procedural volume and improvements in outcomes with robotic esophagectomy has also been identified. Multicentre comparative clinical studies are essential to identify the true objective benefit on outcomes compared with conventional surgical approaches before robotic surgery is accepted as standard of practice.

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