학술논문
Hybrid laparoscopic versus fully robot-assisted minimally invasive esophagectomy: an international propensity-score matched analysis of perioperative outcome
Document Type
Article
Author
Jung, Jin-On; de Groot, Eline M.; Kingma, B. Feike; Babic, Benjamin; Ruurda, Jelle P.; Grimminger, Peter P.; Hölzen, Jens P.; Chao, Yin-Kai; Haveman, Jan W.; van Det, Marc J.; Rouanet, Philippe; Benedix, Frank; Li, Hecheng; Sarkaria, Inderpal; van Berge Henegouwen, Mark I.; van Boxel, Gijs I.; Chiu, Philip; Egberts, Jan-Hendrik; Sallum, Rubens; Immanuel, Arul; Turner, Paul; Low, Donald E.; Hubka, Michal; Perez, Daniel; Strignano, Paolo; Biebl, Matthias; Chaudry, M. Asif; Bruns, Christiane J.; van Hillegersberg, Richard; Fuchs, Hans F.
Source
Surgical Endoscopy; 20230101, Issue: Preprints p1-12, 12p
Subject
Language
ISSN
09302794; 14322218
Abstract
Background: Currently, little is known regarding the optimal technique for the abdominal phase of RAMIE. The aim of this study was to investigate the outcome of robot-assisted minimally invasive esophagectomy (RAMIE) in both the abdominal and thoracic phase (full RAMIE) compared to laparoscopy during the abdominal phase (hybrid laparoscopic RAMIE). Methods: This retrospective propensity-score matched analysis of the International Upper Gastrointestinal International Robotic Association (UGIRA) database included 807 RAMIE procedures with intrathoracic anastomosis between 2017 and 2021 from 23 centers. Results: After propensity-score matching, 296 hybrid laparoscopic RAMIE patients were compared to 296 full RAMIE patients. Both groups were equal regarding intraoperative blood loss (median 200 ml versus 197 ml, p= 0.6967), operational time (mean 430.3 min versus 417.7 min, p= 0.1032), conversion rate during abdominal phase (2.4% versus 1.7%, p= 0.560), radical resection (R0) rate (95.6% versus 96.3%, p= 0.8526) and total lymph node yield (mean 30.4 versus 29.5, p= 0.3834). The hybrid laparoscopic RAMIE group showed higher rates of anastomotic leakage (28.0% versus 16.6%, p= 0.001) and Clavien Dindo grade 3a or higher (45.3% versus 26.0%, p< 0.001). The length of stay on intensive care unit (median 3 days versus 2 days, p= 0.0005) and in-hospital (median 15 days versus 12 days, p< 0.0001) were longer for the hybrid laparoscopic RAMIE group. Conclusions: Hybrid laparoscopic RAMIE and full RAMIE were oncologically equivalent with a potential decrease of postoperative complications and shorter (intensive care) stay after full RAMIE.