Robotic minimally invasive esophagectomy provides superior surgical resection

Ali, Ahmed M.; Bachman, Katelynn C.; Worrell, Stephanie G.; Gray, Kelsey; Perry, Yaron; Linden, Philip A.; Towe, Christopher W.

doi:10.1007/s00464-020-08120-3

Cited by 14 publications

(19 citation statements)

References 13 publications

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“…A total of 507 studies were excluded for the following reasons: 44 were written in a language other than English, 10 were case reports/case series, 97 were reviews, 46 were non-comparative studies, 293 were off-topic and 18 did not provide any usable data. Thus, 35 studies were included in the final analysis, out of which 20 compared robotic vs. laparoscopic surgery, 11 compared robotic vs. open esophagectomy and 4 reported on a three-arms comparison (robotic vs. laparoscopic vs. open) [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ]. From the latter [ 54 ], it was possible to extract only data about the comparison between robotic and laparoscopic esophagectomy.…”

Section: Resultsmentioning

confidence: 99%

“…Ivor-Lewis procedure was performed in four studies [ 39 , 49 , 51 , 56 ], McKeown esophagectomy in ten studies [ 34 , 42 , 43 , 53 , 54 , 57 , 58 , 59 , 60 , 61 ] while nine studies did not specify the intervention [ 31 , 32 , 33 , 40 , 47 , 48 , 50 , 52 , 55 ].…”

Section: Robotic Versus Laparoscopic Esophagectomymentioning

confidence: 99%

“…Intraoperative outcomes are shown in Figure 2 . Operative time was reported by 15 Authors [ 23 , 25 , 26 , 28 , 29 , 30 , 31 , 35 , 37 , 40 , 45 , 46 , 49 , 54 , 57 ] on 2690 procedures (which of 1089 robotic and 1601 laparoscopic), demonstrating a lower operative time in the laparoscopic group (MD = 31, p = 0.003, 95%CI 10.743; 52.478), with a significant heterogeneity among the studies (I 2 = 93.720%, p < 0.0001). Estimated blood loss was analysed by 14 Authors [ 21 , 23 , 28 , 29 , 33 , 37 , 38 , 39 , 42 , 48 , 50 , 51 , 53 , 57 ], on 1977 procedures (which of 995 robotic and 982 laparoscopic), demonstrating no significant differences between the two approaches (MD = 1.673, p = 0.805, 95%CI −11.638; 14.985), with no heterogeneity among the studies (I 2 = 0%, p = 0.760).…”

Section: Robotic Versus Laparoscopic Esophagectomymentioning

confidence: 99%

“…Chylothorax was analysed by 13 Authors [ 23 , 27 , 29 , 32 , 38 , 43 , 45 , 48 , 50 , 51 , 53 , 54 , 57 ] on 2433 procedures (1207 robotic and 1226 laparoscopic), with no significant differences between the two groups (OR = 0.816, p = 0.564, 95%CI 0.409, 1.627), and no significant heterogeneity among the studies (I 2 = 0%, p = 0.954). Mortality was analysed by 17 Authors [ 22 , 23 , 28 , 31 , 32 , 36 , 38 , 41 , 43 , 44 , 45 , 46 , 48 , 50 , 51 , 53 , 54 ] including 3727 patients (1604 robotic and 2123 laparoscopic) with no differences between the two groups (RD = −0.003, p = 0.352, 95%CI −0.011; 0.004) and no significant heterogeneity among the studies (I 2 = 0%, p = 0.962). It was not possible to assess the reoperation rate because no studies reported this data.…”

Section: Robotic Versus Laparoscopic Esophagectomymentioning

confidence: 99%

“…Oncologic outcomes are shown in Figure 4 . Mean number of harvested nodes was reported by 17 Authors [ 31 , 34 , 38 , 40 , 43 , 48 , 49 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ] on 10,707 procedures (which of 3566 robotic and 7141 laparoscopic), demonstrating a higher number in the harvested nodes during the robotic approach (MD = 1.307, p = 0.001, 95%CI 0.553; 2.060), with a significant heterogeneity among the studies (I 2 = 74.857%, p < 0.0001). The number of complete resection (R0 resection) was reported by 12 Authors [ 32 , 38 , 48 , 49 , 50 , 52 , 53 , 56 , 57 , 58 , 60 , 61 ] on 2940 procedures (which of 1469 robotic and 1471 laparoscopic), with no significant differences between the two procedures (RD = 0.005, p = 0.473, 95%CI −0.009; 0.019), and no significant heterogeneity among the studies (I 2 = 20.790%, p = 0.258).…”

Section: Robotic Versus Laparoscopic Esophagectomymentioning

confidence: 99%

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Robotic Esophagectomy. A Systematic Review with Meta-Analysis of Clinical Outcomes

Manigrasso

Vertaldi

Marello

et al. 2021

JPM

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Background: Robot-Assisted Minimally Invasive Esophagectomy is demonstrated to be related with a facilitation in thoracoscopic procedure. To give an update on the state of art of robotic esophagectomy for cancr a systematic review with meta-analysis has been performed. Methods: a search of the studies comparing robotic and laparoscopic or open esophagectomy was performed trough the medical libraries, with the search string “robotic and (oesophagus OR esophagus OR esophagectomy OR oesophagectomy)”. Outcomes were: postoperative complications rate (anastomotic leakage, bleeding, wound infection, pneumonia, recurrent laryngeal nerves paralysis, chylotorax, mortality), intraoperative outcomes (mean blood loss, operative time and conversion), oncologic outcomes (harvested nodes, R0 resection, recurrence) and recovery outcomes (length of hospital stay). Results: Robotic approach is superior to open surgery in terms of blood loss p = 0.001, wound infection rate, p = 0.002, pneumonia rate, p = 0.030 and mean number of harvested nodes, p < 0.0001 and R0 resection rate, p = 0.043. Similarly, robotic approach is superior to conventional laparoscopy in terms of mean number of harvested nodes, p = 0.001 pneumonia rate, p = 0.003. Conclusions: robotic surgery could be considered superior to both open surgery and conventional laparoscopy. These encouraging results should promote the diffusion of the robotic surgery, with the creation of randomized trials to overcome selection bias.

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Section: Resultsmentioning

confidence: 99%

Section: Robotic Versus Laparoscopic Esophagectomymentioning

confidence: 99%

Section: Robotic Versus Laparoscopic Esophagectomymentioning

confidence: 99%

Section: Robotic Versus Laparoscopic Esophagectomymentioning

confidence: 99%

Section: Robotic Versus Laparoscopic Esophagectomymentioning

confidence: 99%

See 3 more Smart Citations

Robotic Esophagectomy. A Systematic Review with Meta-Analysis of Clinical Outcomes

Manigrasso

Vertaldi

Marello

et al. 2021

JPM

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Prince and princesses: The current status of robotic surgery in surgical oncology

Hays,

Corvino,

Lorié

et al. 2023

Journal of Surgical Oncology

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Robotic surgery has experienced a dramatic increase in utilization across general surgery over the last two decades, including in surgical oncology. Although urologists and gynecologists were the first to show that this technology could be utilized in cancer surgery, the robot is now a powerful tool in the treatment of gastrointestinal, hepato–pancreatico–biliary, colorectal, endocrine, and soft tissue malignancies. While long‐term outcomes are still pending, short‐term outcomes have showed promise for this technologic advancement of cancer surgery.

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Short‐term outcomes of robot‐assisted versus thoracoscopic‐assisted Mckeown esophagectomy

Meng

Wang

et al. 2023

Robotics Computer Surgery

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BackgroundThoracoscopic‐assisted and robot‐assisted Mckeown esophagectomy are currently two common surgical methods, but there is no clear statement on the advantages and disadvantages of the two.MethodsThis study conducted a single‐centre retrospective analysis of esophageal cancer patients diagnosed and treated at Lanzhou University Second Hospital from 1 February 2020 to 31 July 2022. According to the inclusion and exclusion criteria, 126 patients were finally included in the RAM group and 169 patients in the TAM group.ResultsThere was no significant difference between the RAM and TAM groups in the number of lymph node dissections, operative time, the length of stay in the intensive care unit after surgery, the incidence of hoarseness, postoperative pulmonary complications, surgery‐related complications, use of opioids after surgery, the length of postoperative hospital stay, and 30‐day mortality.ConclusionsRAM is a minimally invasive alternative to TAM and has similar short‐term oncological efficacy.

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Robotic minimally invasive esophagectomy provides superior surgical resection

Cited by 14 publications

References 13 publications

Robotic Esophagectomy. A Systematic Review with Meta-Analysis of Clinical Outcomes

Robotic Esophagectomy. A Systematic Review with Meta-Analysis of Clinical Outcomes

Prince and princesses: The current status of robotic surgery in surgical oncology

Short‐term outcomes of robot‐assisted versus thoracoscopic‐assisted Mckeown esophagectomy

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