European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2025
From conventional minimally invasive to robotic-assisted Ivor Lewis esophagectomy - A Nordic single-center retrospective study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Hauge Tobias, Johnson Egil, Fasting Magnus, Førland Dag, Skagemo Caroline, Mala Tom
Аннотация
BACKGROUND: High-quality studies from Asia have demonstrated that robotic assisted minimally invasive esophagectomy (RAMIE) is a feasible and comparable alternative to conventional minimally invasive esophagectomy (MIE), evidence regarding its application to Western patients remains limited. This study evaluates the short-term outcomes during the initial phase of RAMIE implementation in comparison to the previous standard MIE technique in a Nordic center.
METHODS: A retrospective single center study of prospectively registered data, comparing short-term outcomes between the final 100 patients operated with MIE and the first 100 patients operated with RAMIE. The primary outcome was the total number of lymph nodes harvested. Secondary outcomes included postoperative pneumonia, anastomotic leakage, serious complications (Clavien Dindo ≥ 3), length of operation, length of hospital stay and resection margin status. An inverse probability weighting model and regression analysis was conducted.
RESULTS: 200 patients were included (RAMIE n = 100, MIE n = 100). Matched groups (RAMIE n = 96, MIE n = 97) showed no difference in total number of lymph nodes harvested (RAMIE 22.1 vs. MIE 23.7, p = 0.50). RAMIE had higher postoperative pneumonia risk (OR = 2.3, p < 0.01), longer length of operation (+33.9 min, p < 0.01) and marginally increased risk of anastomotic leakage (OR = 2.4, p = 0.05). Comparing the last 50 patients operated with RAMIE to the MIE group, there was no difference in length of operation (OR = 10.3, p = 0.43).
CONCLUSION: The short-term oncological outcomes and safety remain secure even during the initial phases of RAMIE implementation in a Nordic cohort. The perioperative outcome for some measures after RAMIE were inferior to MIE, potentially related to learning curve aspects.
METHODS: A retrospective single center study of prospectively registered data, comparing short-term outcomes between the final 100 patients operated with MIE and the first 100 patients operated with RAMIE. The primary outcome was the total number of lymph nodes harvested. Secondary outcomes included postoperative pneumonia, anastomotic leakage, serious complications (Clavien Dindo ≥ 3), length of operation, length of hospital stay and resection margin status. An inverse probability weighting model and regression analysis was conducted.
RESULTS: 200 patients were included (RAMIE n = 100, MIE n = 100). Matched groups (RAMIE n = 96, MIE n = 97) showed no difference in total number of lymph nodes harvested (RAMIE 22.1 vs. MIE 23.7, p = 0.50). RAMIE had higher postoperative pneumonia risk (OR = 2.3, p < 0.01), longer length of operation (+33.9 min, p < 0.01) and marginally increased risk of anastomotic leakage (OR = 2.4, p = 0.05). Comparing the last 50 patients operated with RAMIE to the MIE group, there was no difference in length of operation (OR = 10.3, p = 0.43).
CONCLUSION: The short-term oncological outcomes and safety remain secure even during the initial phases of RAMIE implementation in a Nordic cohort. The perioperative outcome for some measures after RAMIE were inferior to MIE, potentially related to learning curve aspects.