Upper Gastrointestinal Surgery: Robotic Surgery versus Laparoscopic Procedures for Esophageal Malignancy

Biebl, Matthias; Ανδρέου, Ανδρέας; Chopra, Sascha; Denecke, Christian; Pratschke, Johann

doi:10.1159/000487011

Cited by 18 publications

(11 citation statements)

References 55 publications

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“…33,34 Other studies have shown that robotic assisted esophagectomy is technically feasible and has proven good short-term oncologic outcomes. 35 Abbott et al report a cohort of 134 patients finding that the complication rate in patients over the age of 70 years is comparable to younger patients. 36 They also report favorable outcomes for patient with larger body mass index, with comparable operative times and postoperative complication rates.…”

Section: Discussionmentioning

confidence: 98%

Oncologic Resection in Laparoscopic Versus Robotic Transhiatal Esophagectomy

Washington

Watkins

Jay

et al. 2019

JSLS

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Background and Objectives: As the use of robotic surgery continues to increase, little is known about robotic oncologic outcomes compared with traditional methods in esophagectomy. The aim of this study was to examine the perioperative oncologic outcomes of patients undergoing laparoscopic versus robot-assisted transhiatal esophagectomy (THE). Methods: Thirty-six consecutive patients who underwent laparoscopic and robot-assisted THE for malignant disease over a 3-year period were identified in a retrospective database. Eighteen patients underwent robotic-assisted THE with cervical anastomosis, and 18 patients underwent laparoscopic THE. All procedures were performed by a single foregut and thoracic surgeon. Results: Patient demographics were similar between the 2 groups with no significant differences. Lymph node yields for both laparoscopic and robot-assisted THE were similar at 13.9 and 14.3, respectively ( P = .90). Ninety-four percent of each group underwent R0 margins, but only 1 patient from each modality had microscopic positive margins. All of the robot-assisted patients underwent neoadjuvant chemoradiation, whereas 83.3% underwent neoadjuvant therapy in the laparoscopy group ( P = .23). Clinical and pathologic stagings were similar in each group. There was 1 death after laparoscopic surgery in a cirrhotic patient and no mortalities among the robot-assisted THE patients ( P = .99). One patient from each group experienced an anastomotic leak, but neither patient required further intervention. Conclusions: Laparoscopic and robot-assisted THEs yield similar perioperative oncologic results including lymph node yield and margin status. In the transition from laparoscopic surgery, robotic surgery should be considered oncologically noninferior compared with laparoscopy.

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Section: Discussionmentioning

confidence: 98%

Oncologic Resection in Laparoscopic Versus Robotic Transhiatal Esophagectomy

Washington

Watkins

Jay

et al. 2019

JSLS

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“…Transhiatal RAMIE was first introduced in 2003 [11] , and transthoracic RAMIE was introduced a year later [12] . Although RAMIE is still under development, it is now described as a promising minimally invasive operative method with short-term and long-term clinical outcomes that are equivalent to (or perhaps better than) those achieved with OE and MIE [ Table 2] [29] . In a US report, 32.1% of esophageal cancer patients were treated with MIE.…”

Section: Characteristics Of the Operative Approaches To Esophagectomymentioning

confidence: 99%

Trends in the evolution to robot-assisted minimally invasive thoracoscopic esophagectomy

Li¹,

Motoyama²,

Sato³

et al. 2020

Mini-invasive Surg

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Much effort has been made to improve outcomes and/or minimize the invasiveness of esophagectomy for thoracic esophageal cancer. This has led to the evolution from open esophagectomy to thoracoscopic minimally invasive esophagectomy (MIE), and from MIE to robot-assisted minimally invasive esophagectomy (RAMIE). RAMIE is being applied clinically to overcome the limitations of MIE. In this article, we review the trends in the evolution from thoracoscopic MIE to RAMIE. It has now been demonstrated that RAMIE is both safe and feasible, and may decrease morbidity and mortality rates associated with esophagectomy and improve oncological outcomes. On the other hand, there are still many problems that need to be solved.

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“…8). However, it will be difficult to prove a better clinical outcome for the patient compared to conventional MIE [75].…”

Section: Roboticmentioning

confidence: 99%

Minimally invasive esophagectomy

Wykypiel

Schmid

Gehwolf

2019

memo

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Background Minimally invasive techniques have replaced the conventional open approach in many operations. For esophagectomy, it took quite a long time to become routine even in centers. The aim of this review was to demonstrate history and current status of minimally invasive esophagectomy and also robotic-assisted esophagectomy with its associated techniques. Methods Selected literature on minimally invasive surgery for esophageal cancer was identified using a PubMed search for the period 1990-2018 with the search terms esophagectomy, minimal invasive, robotic, indocyanine fluorescein, enhanced recovery after surgery (ERAS), fast-track, nerve monitoring and its permutations. Results Within the last two decades minimally invasive esophagectomy has found its way into clinical practice. It reduces perioperative morbidity with equivalent oncological outcome. It allows for better pulmonary results, less blood loss, less pain, and better quality of life. If robotic assisted esophagectomy helps to further improve the results is currently under investigation. Fast-track protocols have proven their value. Intraoperative nerve monitoring and indocyanine green fluorescein imaging of the perfusion of the gastric tube can lower perioperative complications. Conclusions Minimally invasive surgery for esophageal malignancies offers advantages when performed in an environment with sufficient expertise and caseload. Whether robotic-assisted minimally invasive esophagectomy further improves the results

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Upper Gastrointestinal Surgery: Robotic Surgery versus Laparoscopic Procedures for Esophageal Malignancy

Cited by 18 publications

References 55 publications

Oncologic Resection in Laparoscopic Versus Robotic Transhiatal Esophagectomy

Oncologic Resection in Laparoscopic Versus Robotic Transhiatal Esophagectomy

Trends in the evolution to robot-assisted minimally invasive thoracoscopic esophagectomy

Minimally invasive esophagectomy

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