Please use this identifier to cite or link to this item: http://doi.org/10.25358/openscience-7614
Authors: Grimminger, Peter P.
Staubitz, Julia I.
Perez, Daniel
Ghadban, Tarik
Reeh, Matthias
Scognamiglio, Pasquale
Izbicki, Jakob R.
Biebl, Matthias
Fuchs, Hans
Bruns, Christiane J.
Lang, Hauke
Becker, Thomas
Egberts, Jan-Hendrik
Title: Multicenter experience in robot-assisted minimally invasive esophagectomy : a comparison of hybrid and totally robot-assisted techniques
Online publication date: 24-Aug-2022
Year of first publication: 2021
Language: english
Abstract: Background Oncological esophageal surgery has evolved significantly in the last decades. From open esophagectomy over (hybrid) minimally invasive surgery, nowadays, robot-assisted minimally invasive esophagectomy (RAMIE) approaches are applied. Current techniques require an analysis of possible advantages and disadvantages indicating the direction towards a novel gold standard. Methods Robot-assisted Ivor Lewis esophagectomies, performed in the period from April 2017 to June 2019 in five German centers (Berlin, Cologne, Hamburg, Kiel, Mainz), were included in this study. Pre-, intra-, and postoperative parameters were assessed. Cases were grouped for hybrid (H-RAMIE) versus totally robot-assisted (T-RAMIE) approaches. Postoperative parameters and complications were compared using risk ratios. Results A total of 175 operations were performed as T-RAMIE and 67 as H-RAMIE. Patient age (median age 62 years) and sex (83.1% male) were similarly distributed in both groups. Median duration of esophagectomy was significantly lower in the T-RAMIE group (385 versus 427 min, p < 0.001). The risks of “overall morbidity” (32.0 versus 47.8%; risk ratio [RR], 95% confidence interval (CI): 1.5, 1.1–2.1; p = 0.026), “anastomotic leak” (10.3 versus 22.4%; RR, CI: 2.2, 1.2–4.1; p = 0.020), and “respiratory failure” (1.1 versus 7.5%; RR, CI: 6.5, 1.3–32.9; p = 0.019) were significantly higher in case of H-RAMIE. Conclusions In the five participating German centers, T-RAMIE was the preferred procedure (72.3% of operations). In comparison to H-RAMIE, T-RAMIE was associated with a significantly reduced risk of postoperative morbidity, anastomotic leak, and respiratory failure as well as a significantly reduced time necessary for esophagectomy.
DDC: 610 Medizin
610 Medical sciences
Institution: Johannes Gutenberg-Universität Mainz
Department: FB 04 Medizin
Place: Mainz
ROR: https://ror.org/023b0x485
DOI: http://doi.org/10.25358/openscience-7614
Version: Published version
Publication type: Zeitschriftenaufsatz
License: CC BY
Information on rights of use: https://creativecommons.org/licenses/by/4.0/
Journal: Journal of gastrointestinal surgery
25
Pages or article number: 2463
2469
Publisher: Springer
Publisher place: New York, NY
Issue date: 2021
ISSN: 1873-4626
Publisher DOI: 10.1007/s11605-021-05044-8
Appears in collections:JGU-Publikationen

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