Robotic Esophagectomy Compared With Open Esophagectomy Reduces Sarcopenia within the First Postoperative Year: A Propensity Score-Matched Analysis

Merboth, Felix; Nebelung, Heiner; Wotschel, Natalie; Liebscher, Hendrik; Eckert, Franziska; Renesse, Janusz von; Hasanovic, Jasmin; Welsch, Thilo; Fritzmann, Johannes; Stange, Daniel E.; Plodeck, Verena; Hoffmann, Ralf‐Thorsten; Distler, Marius; Weitz, Jürgen; Kirchberg, Johanna

doi:10.1016/j.jtho.2022.10.018

Cited by 5 publications

(4 citation statements)

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“…At present, the rate of minimally invasive resection in some centers is as high as 80-90%, which can reduce the occurrence of postoperative complications, improve quality of life, and further improve patient survival. [15][16][17][18][19][20] Our previous study confirmed that robot-assisted minimally invasive esophagectomy (RAMIE) showed significant advantages over traditional endoscopic surgery by increasing upper mediastinal lymph node harvest and reducing the incidence of recurrent laryngeal nerve paralysis. 21 Whether RAMIE is safe and feasible for patients with ESCC who undergo NCI has not yet been reported.…”

Section: Introductionmentioning

confidence: 73%

“…Technical innovations in esophageal surgery include the transition from open to minimally invasive procedures, especially the introduction and application of da Vinci robotic surgery. At present, the rate of minimally invasive resection in some centers is as high as 80–90%, which can reduce the occurrence of postoperative complications, improve quality of life, and further improve patient survival 15–20 . Our previous study confirmed that robot‐assisted minimally invasive esophagectomy (RAMIE) showed significant advantages over traditional endoscopic surgery by increasing upper mediastinal lymph node harvest and reducing the incidence of recurrent laryngeal nerve paralysis 21 .…”

Section: Introductionmentioning

confidence: 90%

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Neoadjuvant chemoimmunotherapy followed by robot esophagectomy has no effect on short‐term results compared with surgery alone

Guo,

Zhang,

Zhao

et al. 2024

Thoracic Cancer

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BackgroundTo determine the safety and efficacy of robot‐assisted minimally invasive esophagectomy (RAMIE) for locally advanced esophageal squamous cell carcinoma (ESCC) after neoadjuvant chemoimmunotherapy (NCI).MethodsData from patients who underwent RAMIE between January 2020 and June 2022 were retrospectively analyzed. The oncological and operative outcomes of the NCI and surgery‐only (S) groups were compared by both unmatched and 1:1 propensity score‐matched (PSM) analysis.ResultsA total of 201 patients with ESCC who underwent three‐incision RAMIE were included in this study (143 patients in the S group and 58 patients in the NCI group). Of the 58 patients who underwent NCI, a pathologically complete response (pCR) (ypT0N0) was identified in 14 (24.1%) patients. The patients in the NCI group were younger than those in the S group (p = 0.017), and had more advanced cT (p < 0.001) and cN stage diseases (p = 0.002). After 1:1 PSM of the confounders, 55 patients were allocated to each of the NCI and S groups. No significant differences were found in oncological and operative results, including surgical blood loss, operative time, and lymph node harvest (all p > 0.05). However, the NCI group exhibited a lower rate of pulmonary complications than the S group (3.6% vs. 14.5%, p = 0.047). No significant difference between the groups was found for other complications (all p > 0.05).ConclusionThese findings indicate that NCI could result in a high pCR rate without increased complications in locally advanced ESCC. RAMIE is safe and feasible in patients with ESCC after NCI.

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Section: Introductionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 90%

Neoadjuvant chemoimmunotherapy followed by robot esophagectomy has no effect on short‐term results compared with surgery alone

Guo,

Zhang,

Zhao

et al. 2024

Thoracic Cancer

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“…The study protocol was reviewed by a local ethics committee (EK-84022022) and was performed in accordance with the Declaration of Helsinki and its later amendments. Some of the analyzed patient collectives have already been published regarding other end points (19,20).…”

Section: Study Design and Populationmentioning

confidence: 99%

Single chest drain is not inferior to double chest drain after robotic esophagectomy: a propensity score-matched analysis

et al. 2023

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BackgroundChest drain management has a significant influence on postoperative recovery after robot-assisted minimally invasive esophagectomy (RAMIE). The use of chest drains increases postoperative pain by irritating intercostal nerves and hinders patients from early postoperative mobilization and recovery. To our knowledge, no study has investigated the use of two vs. one intercostal chest drains after RAMIE.MethodsThis retrospective cohort study evaluated patients undergoing elective RAMIE with gastric conduit pull-up and intrathoracic anastomosis. Patients were divided into two groups according to placement of one (11/2020–08/2022) or two (08/2018–11/2020) chest drains. Propensity score matching was performed in a 1:1 ratio, and the incidences of overall and pulmonary complications, drainage-associated re-interventions, radiological diagnostics, analgesic use, and length of hospital stay were compared between single drain and double drain groups.ResultsDuring the study period, 194 patients underwent RAMIE. Twenty-two patients were included after propensity score matching in the single and double chest drain group, respectively. Time until removal of the last chest drain [postoperative day (POD) 6.7 ± 4.4 vs. POD 9.4 ± 2.7, p = 0.004] and intensive care unit stay (4.2 ± 5.1 days vs. 5.3 ± 3.5 days, p = 0.01) were significantly shorter in the single drain group. Overall and pulmonary complications, drainage-associated events, re-interventions, number of diagnostic imaging, analgesic use, and length of hospital stay were comparable between both groups.ConclusionThis study is the first to demonstrate the safety of single intercostal chest drain use and, at least, non-inferiority to double chest drains in terms of perioperative complications after RAMIE.

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“…The advantages of minimally invasive esophagectomy compared with open esophagectomy include decreased postoperative pain, decreased length of hospital stay, and fewer complications ( 15 , 16 ). Furthermore, surgical robots have been used widely to perform esophageal cancer operations, with positive clinical outcomes ( 17 , 18 ). Technological advancement has also brought numerous improvements to RT and chemotherapy ( 2 , 12 ).…”

Section: Introductionmentioning

confidence: 99%

Treatment and survival analysis for 40-year SEER data on upper esophageal cancer

Zhu

et al. 2023

Front. Med.

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BackgroundUpper esophageal cancer (UEC) is rare in both Eastern and Western countries. The epidemiological characteristics and long-term survival of UEC patients are less known. In addition, the choice of optimal treatment for UEC has been controversial.MethodsCases of UEC (C15.3 and C15.0) arising during the period from 1973 to 2013 were identified and selected using the SEER database. Student's t-test and Pearson's chi-square test were used to compare the differences in parameters among different groups. Esophageal cancer-specific survival (ECSS) and overall survival (OS) rates were calculated by using the Kaplan–Meier method. Cox proportional hazard regression was used to analyze predictive factors.ResultsIn the past 40 years, the cases of UEC have gradually increased, and the proportion of adenocarcinoma (AD) has gradually increased (from 3.6% to 11.8%, p < 0.001). There has been a significant increase (1973–1982 vs. 2004–2013) in median OS (7 months vs. 10 months, p < 0.001) and median ECSS (7 months vs. 11 months, p < 0.001) among UEC patients from 1973 to 2013. For the impact of different treatments, the results showed that the ECSS and OS of surgery without radiation (SWR) and radiation plus surgery (R+S) were superior to those of radiation without surgery (RWS). Subgroup analysis showed that ECSS and OS were highest among patients treated with SWR compared with R+S and RWS for patients with localized disease. For regional disease, ECSS and OS were highest among patients with R+S compared with SWR or RWS. Among patients with regional-stage squamous cell carcinoma (SCC), OS was higher with neoadjuvant radiotherapy or adjuvant radiotherapy compared with SWR. Multivariate analysis showed that radiotherapy sequence was dependently associated with OS among patients with regional-stage SCC.ConclusionAlthough the long-term survival of UEC remains poor, it has gradually increased since 1973. This should be closely related to the improvement of medical care over the past 40 years. Different treatment methods have a great influence on the long-term survival of UEC. For localized diseases, surgery may be a better choice. For regional disease, surgery plus adjuvant or neoadjuvant radiotherapy may be more beneficial to improve the long-term prognosis of UEC patients.

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Robotic Esophagectomy Compared With Open Esophagectomy Reduces Sarcopenia within the First Postoperative Year: A Propensity Score-Matched Analysis

Cited by 5 publications

References 50 publications

Neoadjuvant chemoimmunotherapy followed by robot esophagectomy has no effect on short‐term results compared with surgery alone

Neoadjuvant chemoimmunotherapy followed by robot esophagectomy has no effect on short‐term results compared with surgery alone

Single chest drain is not inferior to double chest drain after robotic esophagectomy: a propensity score-matched analysis

Treatment and survival analysis for 40-year SEER data on upper esophageal cancer

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