Autoren:	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
Titel:	Multicenter experience in robot-assisted minimally invasive esophagectomy : a comparison of hybrid and totally robot-assisted techniques
Online-Publikationsdatum:	24-Aug-2022
Erscheinungsdatum:	2021
Sprache des Dokuments:	Englisch
Zusammenfassung/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-Sachgruppe:	610 Medizin 610 Medical sciences
Veröffentlichende Institution:	Johannes Gutenberg-Universität Mainz
Organisationseinheit:	FB 04 Medizin
Veröffentlichungsort:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-7614
Version:	Published version
Publikationstyp:	Zeitschriftenaufsatz
Nutzungsrechte:	CC BY
Informationen zu den Nutzungsrechten:	https://creativecommons.org/licenses/by/4.0/
Zeitschrift:	Journal of gastrointestinal surgery 25
Seitenzahl oder Artikelnummer:	2463 2469
Verlag:	Springer
Verlagsort:	New York, NY
Erscheinungsdatum:	2021
ISSN:	1873-4626
DOI der Originalveröffentlichung:	10.1007/s11605-021-05044-8
Enthalten in den Sammlungen:	JGU-Publikationen