Hybrid laparoscopic versus fully robot-assisted minimally invasive esophagectomy: an international propensity-score matched analysis of perioperative outcome

Jin-On Jung; Eline M de Groot; B Feike Kingma; Benjamin Babic; Jelle P Ruurda; Peter P Grimminger; Jens P Hölzen; Yin-Kai Chao; Jan W Haveman; Marc J van Det; Philippe Rouanet; Frank Benedix; Hecheng Li; Inderpal Sarkaria; Mark I van Berge Henegouwen; Gijs I van Boxel; Philip Chiu; Jan-Hendrik Egberts; Rubens Sallum; Arul Immanuel; Paul Turner; Donald E Low; Michal Hubka; Daniel Perez; Paolo Strignano; Matthias Biebl; M Asif Chaudry; Christiane J Bruns; Richard van Hillegersberg; Hans F Fuchs; UGIRA Study Group

doi:10.1007/s00464-023-09911-0

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Hybrid laparoscopic versus fully robot-assisted minimally invasive esophagectomy: an international propensity-score matched analysis of perioperative outcome

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Hybrid laparoscopic versus fully robot-assisted minimally invasive esophagectomy: an international propensity-score matched analysis of perioperative outcome

Jin-On Jung, Eline M de Groot, B Feike Kingma, Benjamin Babic, Jelle P Ruurda, Peter P Grimminger, Jens P Hölzen, Yin-Kai Chao, Jan W Haveman, Marc J van Det, …

Surgical endoscopy, Vol.37(6), pp.4466-4477

01/06/2023

DOI: https://doi.org/10.1007/s00464-023-09911-0

PMID: 36808472

Résumé

Propensity-score matching

Hybrid laparoscopic approach

Perioperative outcome

RAMIE

Robot-assisted minimally invasive esophagectomy

Complications

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). 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. 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. Hybrid laparoscopic RAMIE and full RAMIE were oncologically equivalent with a potential decrease of postoperative complications and shorter (intensive care) stay after full RAMIE.

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Détails

Titre: Hybrid laparoscopic versus fully robot-assisted minimally invasive esophagectomy: an international propensity-score matched analysis of perioperative outcome
Créateurs - sans rôle: Jin-On Jung - Department of General, Visceral and Tumor Surgery, University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
Eline M de Groot - Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
B Feike Kingma - Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
Benjamin Babic - Department of General, Visceral and Tumor Surgery, University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
Jelle P Ruurda - Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
Peter P Grimminger - Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Mainz, Germany
Jens P Hölzen - Department of General, Visceral and Transplant Surgery, University Hospital Münster, Münster, Germany
Yin-Kai Chao - Department of Thoracic Surgery, Chang Gung Memorial Hospital-Linkou Taoyuan, Taoyuan, Taiwan
Jan W Haveman - Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands
Marc J van Det - Department of Surgery, ZGT Hospital Almelo, Almelo, The Netherlands
Philippe Rouanet - Institut Regional du Cancer de Montpellier
Frank Benedix - Department of Surgery, University Hospital Magdeburg, Magdeburg, Germany
Hecheng Li - Department of Thoracic Surgery, Ruijin Hospital Shanghai, Shanghai, China
Inderpal Sarkaria - Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, USA
Mark I van Berge Henegouwen - Department of Surgery, University Medical Center Amsterdam, Amsterdam, The Netherlands
Gijs I van Boxel - Department of General Surgery, Portsmouth Hospitals NHS Trust, Portsmouth, UK
Philip Chiu - Department of Surgery at Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
Jan-Hendrik Egberts - Department of Surgery, Israelitisches Krankenhaus Hamburg, Hamburg, Germany
Rubens Sallum - Department of Digestive Surgery, University of São Paulo, São Paulo, Brasil
Arul Immanuel - Department of Surgery, Royal Victoria Infirmary Newcastle Upon Tyne, Newcastle upon Tyne, UK
Paul Turner - Department of Oesophagogastric Surgery, Lancashire Teaching Hospitals NHS Trust, Preston, UK
Donald E Low - Department of Thoracic Surgery and Thoracic Oncology, Virginia Mason Medical Center Seattle, Seattle, USA
Michal Hubka - Department of Thoracic Surgery and Thoracic Oncology, Virginia Mason Medical Center Seattle, Seattle, USA
Daniel Perez - Department of General, Visceral, and Thoracic Surgery, University Medical Center Hamburg, Hamburg, Germany
Paolo Strignano - Department of General Surgery, Citta' della Salute e della Scienza Turin, Turin, Italy
Matthias Biebl - Department of Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
M Asif Chaudry - Department of Academic Surgery, The Royal Marsden NHS Foundation Trust London, London, UK
Christiane J Bruns - Department of General, Visceral and Tumor Surgery, University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
Richard van Hillegersberg - Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
Hans F Fuchs - Department of General, Visceral and Tumor Surgery, University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany. hans.fuchs@uk-koeln.de
UGIRA Study Group
Détails de publication: Surgical endoscopy, Vol.37(6), pp.4466-4477
Identifiants: 99149006209311
Unité académique: Recherche hors université
Langue: English
Type de ressource: Journal article