The Current State of Robot-Assisted Minimally Invasive Esophagectomy (RAMIE): Outcomes from the Upper GI International Robotic Association (UGIRA) Esophageal Registry.

Autor: Kooij CD; University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands., de Jongh C; University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands., Kingma BF; University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands., van Berge Henegouwen MI; Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Amsterdam, The Netherlands., Gisbertz SS; Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Amsterdam, The Netherlands., Chao YK; Chang Gung Memorial Hospital-Linko, Chang Gung University, Taoyuan, Taiwan., Chiu PW; Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China., Rouanet P; Montpellier Cancer Institute, Montpellier, France., Mourregot A; Montpellier Cancer Institute, Montpellier, France., Immanuel A; Royal Victoria Infirmary Newcastle Upon Tyne, Newcastle upon Tyne, UK., Mala T; Department of Gastrointestinal Surgery, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway., van Boxel GI; Portsmouth Hospitals NHS Trust, Portsmouth, UK., Carter NC; Portsmouth Hospitals NHS Trust, Portsmouth, UK., Li H; Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China., Fuchs HF; University of Cologne, Cologne, Germany., Bruns CJ; University of Cologne, Cologne, Germany., Giacopuzzi S; University of Verona, Verona, Italy., Kalff JC; University Hospital of Bonn, Bonn, Germany., Hölzen JP; Universitätsklinikum Münster, Münster, Germany., Juratli MA; Universitätsklinikum Münster, Münster, Germany., Benedix F; University Hospital Magdeburg, Magdeburg, Germany., Lorenz E; University Hospital Magdeburg, Magdeburg, Germany., Egberts JH; Israelitisches Krankenhaus Hamburg, Hamburg, Germany., Haveman JW; University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., van Etten B; University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Müller BP; University Digestive Healthcare, Basel, Switzerland., Grimminger PP; University Medical Center of the Johannes Gutenberg University, Mainz, Germany., Berlth F; University Medical Center of the Johannes Gutenberg University, Mainz, Germany., Piessen G; Univ. Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277 - CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, Lille, France., van den Berg JW; University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands., Milone M; 'Federico II' University of Naples, Naples, Italy., Luketich JD; University Pittsburgh Medical Center, Pittsburgh, PA, USA., Sarkaria IS; University of Texas Southwestern Medical Center, Dallas, TX, USA., Sallum RAA; University of São Paulo, São Paulo, Brazil., van Det MJ; ZGT Almelo, Almelo, The Netherlands., Kouwenhoven EA; ZGT Almelo, Almelo, The Netherlands., Brüwer M; St. Franziskus Hospital, Münster, Germany., Harustiak T; Motol University Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic., Kinoshita T; National Cancer Center Hospital East, Chiba, Japan., Fujita T; National Cancer Center Hospital East, Chiba, Japan., Daiko H; National Cancer Center Hospital, Tokyo, Japan., Li Z; Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China., Ruurda JP; University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands., van Hillegersberg R; University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands. R.vanHillegersberg@umcutrecht.nl.
Jazyk: angličtina
Zdroj: Annals of surgical oncology [Ann Surg Oncol] 2024 Nov 04. Date of Electronic Publication: 2024 Nov 04.
DOI: 10.1245/s10434-024-16364-9
Abstrakt: Background: Robot-assisted minimally invasive esophagectomy (RAMIE) is increasingly adopted in centers worldwide, with ongoing refinements to enhance results. This study aims to assess the current state of RAMIE worldwide and to identify potential areas for improvement.
Methods: This descriptive study analyzed prospective data from esophageal cancer patients who underwent transthoracic RAMIE in Upper GI International Robotic Association (UGIRA) centers. Main endpoints included textbook outcome rate, surgical techniques, and perioperative outcomes. Analyses were performed separately for intrathoracic (Ivor-Lewis) and cervical anastomosis (McKeown), divided into three time cohorts (2016-2018, 2019-2020, 2021-2023). A sensitivity analysis was conducted with cases after the learning curve (> 70 cases).
Results: Across 28 UGIRA centers, 2012 Ivor-Lewis and 1180 McKeown procedures were performed. Over the time cohorts, textbook outcome rates were 39%, 48%, and 49% for Ivor-Lewis, and 49%, 63%, and 61% for McKeown procedures, respectively. Fully robotic procedures accounted for 66%, 51%, and 60% of Ivor-Lewis procedures, and 53%, 81%, and 66% of McKeown procedures. Lymph node yield showed 27, 30, and 30 nodes in Ivor-Lewis procedures, and 26, 26, and 34 nodes in McKeown procedures. Furthermore, high mediastinal lymphadenectomy was performed in 65%, 43%, and 37%, and 70%, 48%, and 64% of Ivor-Lewis and McKeown procedures, respectively. Anastomotic leakage rates were 22%, 22%, and 16% in Ivor-Lewis cases, and 14%, 12%, and 11% in McKeown cases. Hospital stay was 13, 14, and 13 days for Ivor-Lewis procedures, and 12, 9, and 11 days for McKeown procedures. In Ivor-Lewis and McKeown, respectively, the sensitivity analysis revealed textbook outcome rates of 43%, 54%, and 51%, and 47%, 64%, and 64%; anastomotic leakage rates of 28%, 18%, and 15%, and 13%, 11%, and 10%; and hospital stay of 11, 12, and 12 days, and 10, 9, and 9 days.
Conclusions: This study demonstrates favorable outcomes over time in achieving textbook outcome after RAMIE. Areas for improvement include a reduction of anastomotic leakage and shortening of hospital stay.
(© 2024. The Author(s).)
Databáze: MEDLINE
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