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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2019

01-05-2019 | Esophageal Cancer | Thoracic Oncology

Early Outcomes of Robot-Assisted Versus Thoracoscopic-Assisted Ivor Lewis Esophagectomy for Esophageal Cancer: A Propensity Score-Matched Study

Authors: Yajie Zhang, MD, PhD, Yu Han, MD, Qinyi Gan, MD, Jie Xiang, MD, Runsen Jin, MD, PhD, Kai Chen, MD, Jiaming Che, MD, Junbiao Hang, MD, Hecheng Li, MD, PhD

Published in: Annals of Surgical Oncology | Issue 5/2019

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Abstract

Background

Both robot-assisted Ivor Lewis esophagectomy (RAILE) and conventional thoracoscopic-assisted Ivor Lewis esophagectomy (TAILE) are minimally invasive surgical techniques for the treatment of middle and distal esophageal cancer. However, no research studies comparing early outcomes between RAILE and TAILE have been reported.

Methods

A retrospective analysis was made of 184 patients, 76 in the RAILE group and 108 in the TAILE group, who underwent minimally invasive Ivor Lewis esophagectomy between December 2014 and June 2018. Propensity score-matched analysis was performed between the two groups based on demographics, comorbidities, American Society of Anesthesiologists score, tumor location, tumor size, and pathological stage. Perioperative outcomes were compared.

Results

Two conversions to thoracotomy occurred in the RAILE group. There was no 30-day in either group. Sixty-six matched pairs were identified for each group. Within the propensity score-matched cohorts, the operative time in the RAILE group was significantly longer than that in the TAILE group (302.0 ± 62.9 vs. 274.7 ± 38.0 min, P = 0.004). There was no significant difference in the blood loss [200.0 ml (interquartile range [IQR], 100.0–262.5 ml) vs. 200.0 ml (150.0–245.0 ml), P = 0.100], rates of overall complications (28.8 vs. 24.2%, P = 0.554), length of stay [9.0 days (IQR 8.0–12.3 days) vs. 9.0 days (IQR 8.0–11.3 days), P = 0.517], the number of total dissected lymph nodes (19.2 ± 9.2 vs. 19.3 ± 9.5, P = 0.955), and detailed categories of lymph nodes.

Conclusions

RAILE demonstrated comparable early outcomes compared with TAILE and should be considered as an alternative minimally invasive option for treating esophageal cancer.
Literature
1.
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.
2.
Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin. 2016;66(2):115–32.CrossRefPubMed
3.
Lagergren J, Smyth E, Cunningham D, Lagergren P. Oesophageal cancer. Lancet. 2017;390(10110):2383–96.CrossRefPubMed
4.
Napier KJ, Scheerer M, Misra S. Esophageal cancer: a review of epidemiology, pathogenesis, staging workup and treatment modalities. World J Gastrointest Oncol. 2014;6(5):112–20.CrossRefPubMedPubMedCentral
5.
Lewis I. The surgical treatment of carcinoma of the oesophagus; with special reference to a new operation for growths of the middle third. Br J Surg. 1946;34:18–31.CrossRefPubMed
6.
Boone J, Livestro DP, Elias SG, Borel Rinkes IH, van Hillegersberg R. International survey on esophageal cancer: part I surgical techniques. Dis Esophagus. 2009;22(3):195–202.CrossRefPubMed
7.
Hulscher JB, Tijssen JG, Obertop H, van Lanschot JJ. Transthoracic versus transhiatal resection for carcinoma of the esophagus: a meta-analysis. Ann Thorac Surg. 2001;72(1):306–13.CrossRefPubMed
8.
Lazzarino AI, Nagpal K, Bottle A, Faiz O, Moorthy K, Aylin P. Open versus minimally invasive esophagectomy: trends of utilization and associated outcomes in England. Annals Surg. 2010;252(2):292–8.CrossRef
9.
Moon DH, Lee JM, Jeon JH, Yang HC, Kim MS. Clinical outcomes of video-assisted thoracoscopic surgery esophagectomy for esophageal cancer: a propensity score-matched analysis. J Thorac Dis. 2017;9(9):3005–12.CrossRefPubMedPubMedCentral
10.
Zhang Y, Xiang J, Han Y, et al. Initial experience of robot-assisted Ivor-Lewis esophagectomy: 61 consecutive cases from a single Chinese institution. Dis Esophagus. 2018;31(12):doy048.
11.
Cerfolio RJ, Bryant AS, Hawn MT. Technical aspects and early results of robotic esophagectomy with chest anastomosis. J Thorac Cardiovasc Surg. 2013;145(1):90–6.CrossRefPubMed
12.
Hodari A, Park KU, Lace B, Tsiouris A, Hammoud Z. Robot-assisted minimally invasive ivor lewis esophagectomy with real-time perfusion assessment. Ann Thorac Surg. 2015;100(3):947–52.CrossRefPubMed
13.
Wee JO, Bravo-Iniguez CE, Jaklitsch MT. Early experience of robot-assisted esophagectomy with circular end-to-end stapled anastomosis. Ann Thorac Surg. 2016;102(1):253–9.CrossRefPubMed
14.
Talsma K, van Hagen P, Grotenhuis BA, et al. Comparison of the 6th and 7th editions of the UICC-AJCC TNM classification for esophageal cancer. Ann Surg Oncol. 2012;19(7):2142–8.CrossRefPubMedPubMedCentral
15.
Giulianotti PC, Coratti A, Angelini M, et al. Robotics in general surgery: personal experience in a large community hospital. Arch Surg. 2003;138(7):777–84.CrossRefPubMed
16.
17.
van der Sluis PC, Ruurda JP, Verhage RJ, et al. Oncologic long-term results of robot-assisted minimally invasive thoraco-laparoscopic esophagectomy with two-field lymphadenectomy for esophageal cancer. Ann Surg Oncol. 2015;22 Suppl 3:S1350-6.CrossRefPubMed
18.
Kernstine KH. The first series of completely robotic esophagectomies with three-field lymphadenectomy: initial experience. Surg Endosc. 2008;22(9):2102.CrossRefPubMed
19.
Dunn DH, Johnson EM, Morphew JA, Dilworth HP, Krueger JL, Banerji N. Robot-assisted transhiatal esophagectomy: a 3-year single-center experience. Dis Esophagus 2013;26(2):159–66.CrossRefPubMed
20.
de la Fuente SG, Weber J, Hoffe SE, Shridhar R, Karl R, Meredith KL. Initial experience from a large referral center with robotic-assisted Ivor Lewis esophagogastrectomy for oncologic purposes. Surg Endosc. 2013;27(9):3339–47.CrossRefPubMed
21.
Sarkaria IS, Rizk NP, Grosser R, et al. Attaining proficiency in robotic-assisted minimally invasive esophagectomy while maximizing safety during procedure development. Innovations. 2016;11(4):268–73.CrossRefPubMed
22.
Sarkaria IS, Rizk NP, Finley DJ, et al. Combined thoracoscopic and laparoscopic robotic-assisted minimally invasive esophagectomy using a four-arm platform: experience, technique and cautions during early procedure development. Eur J Cardio-thorac Surg. 2013;43(5):e107–15.CrossRef
23.
Park S, Hwang Y, Lee HJ, Park IK, Kim YT, Kang CH. Comparison of robot-assisted esophagectomy and thoracoscopic esophagectomy in esophageal squamous cell carcinoma. J Thorac Dis. 2016;8(10):2853–61.CrossRefPubMedPubMedCentral
24.
Deng HY, Huang WX, Li G, et al. Comparison of short-term outcomes between robot-assisted minimally invasive esophagectomy and video-assisted minimally invasive esophagectomy in treating middle thoracic esophageal cancer. Dis Esophagus. 2018; 31(8):doy012.
25.
Tsurumaru M, Kajiyama Y, Udagawa H, Akiyama H. Outcomes of extended lymph node dissection for squamous cell carcinoma of the thoracic esophagus. Ann Thorac Cardiovasc Surg. 2001;7(6):325–9.PubMed
26.
van der Horst S, Weijs TJ, Ruurda JP, et al. Robot-assisted minimally invasive thoraco-laparoscopic esophagectomy for esophageal cancer in the upper mediastinum. J Thorac Dis. 2017;9(Suppl 8):S834–42.CrossRefPubMedPubMedCentral
27.
Okusanya OT, Sarkaria IS, Hess NR, et al. Robotic assisted minimally invasive esophagectomy (RAMIE): the University of Pittsburgh Medical Center initial experience. Ann Cardiothorac Surg. 2017;6(2):179–85.CrossRefPubMedPubMedCentral
28.
Chao YK, Hsieh MJ, Liu YH, Liu HP. Lymph node evaluation in robot-assisted versus video-assisted thoracoscopic esophagectomy for esophageal squamous cell carcinoma: a propensity-matched analysis. World J Surg. 2018;42(2):590–8.CrossRefPubMed
29.
He H, Wu Q, Wang Z, et al. Short-term outcomes of robot-assisted minimally invasive esophagectomy for esophageal cancer: a propensity score matched analysis. J Cardiothorac Surg. 23 2018;13(1):52.
30.
Weksler B, Sharma P, Moudgill N, Chojnacki KA, Rosato EL. Robot-assisted minimally invasive esophagectomy is equivalent to thoracoscopic minimally invasive esophagectomy. Dis Esophagus. 2012;25(5):403–9.CrossRefPubMed
31.
Maas KW, Biere SS, Scheepers JJ, et al. Minimally invasive intrathoracic anastomosis after Ivor Lewis esophagectomy for cancer: a review of transoral or transthoracic use of staplers. Surg Endosc. 2012;26(7):1795–802.CrossRefPubMedPubMedCentral
32.
Elshaer M, Gravante G, Tang CB, Jayanthi NV. Totally minimally invasive two-stage esophagectomy with intrathoracic hand-sewn anastomosis: short-term clinical and oncological outcomes. Dis Esophagus. 2018;31(3):dox150.
33.
Cadiere GB, Dapri G, Himpens J, Fodderie L, Rajan A. Ivor Lewis esophagectomy with manual esogastric anastomosis by thoracoscopy in prone position and laparoscopy. Surg Endosc. 2010;24(6):1482–5.CrossRefPubMed
34.
Diez Del Val I, Loureiro Gonzalez C, Larburu Etxaniz S, et al. Contribution of robotics to minimally invasive esophagectomy. J Robotic Surg. 2013;7(4):325–32.CrossRef
35.
Trugeda S, Fernandez-Diaz MJ, Rodriguez-Sanjuan JC, Palazuelos CM, Fernandez-Escalante C, Gomez-Fleitas M. Initial results of robot-assisted Ivor-Lewis oesophagectomy with intrathoracic hand-sewn anastomosis in the prone position. Int J Med Robot. 2014;10(4):397–403.CrossRefPubMed
36.
Bongiolatti S, Annecchiarico M, Di Marino M, et al. Robot-sewn Ivor-Lewis anastomosis: preliminary experience and technical details. Int J Med Robot. 2016;12(3):421–426.CrossRefPubMed
37.
van der Sluis PC, Ruurda JP, van der Horst S, Goense L, van Hillegersberg R. Learning curve for robot-assisted minimally invasive thoracoscopic esophagectomy: results from 312 cases. Ann Thorac Surg. 2018;106(1):264–71.CrossRefPubMed
38.
Tapias LF, Morse CR. Minimally invasive Ivor Lewis esophagectomy: description of a learning curve. J Am Coll Surg. 2014;218(6):1130–40.CrossRefPubMed
Metadata
Title
Early Outcomes of Robot-Assisted Versus Thoracoscopic-Assisted Ivor Lewis Esophagectomy for Esophageal Cancer: A Propensity Score-Matched Study
Authors
Yajie Zhang, MD, PhD
Yu Han, MD
Qinyi Gan, MD
Jie Xiang, MD
Runsen Jin, MD, PhD
Kai Chen, MD
Jiaming Che, MD
Junbiao Hang, MD
Hecheng Li, MD, PhD
Publication date
01-05-2019
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 5/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-07273-3

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