Worldwide Techniques and Outcomes in Robot-assisted Minimally Invasive Esophagectomy (RAMIE) Results From the Multicenter International Registry

被引：59

作者：

Kingma, B. Feike ^{[1
]}

Grimminger, Peter P. ^{[2
]}

van der Sluis, Pieter C. ^{[1
,2
]}

van Det, Marc J. ^{[3
]}

Kouwenhoven, Ewout A. ^{[3
]}

Chao, Yin-Kai ^{[4
]}

Tsai, Chun-Yi ^{[4
]}

Fuchs, Hans F. ^{[5
]}

Bruns, Christiane J. ^{[5
]}

Sarkaria, Inderpal S. ^{[6
]}

Luketich, James D. ^{[6
]}

Haveman, Jan W. ^{[7
]}

van Etten, Boudewijn ^{[7
]}

Chiu, Philip W. ^{[8
]}

Chan, Shannon M. ^{[8
]}

Rouanet, Philippe ^{[9
]}

Mourregot, Anne ^{[9
]}

Hoelzen, Jens-Peter ^{[10
]}

Sallum, Rubens A. ^{[11
]}

Cecconello, Ivan ^{[11
]}

Egberts, Jan-Hendrik ^{[12
]}

Benedix, Frank ^{[13
]}

Henegouwen, Mark I. van Berge ^{[14
]}

Gisbertz, Suzanne S. ^{[14
]}

Perez, Daniel ^{[15
]}

Jansen, Kristina ^{[16
]}

Hubka, Michal ^{[16
]}

Low, Donald E. ^{[16
]}

Biebl, Matthias ^{[17
]}

Pratschke, Johann ^{[17
]}

Turner, Paul ^{[18
]}

Pursnani, Kish ^{[18
]}

Chaudry, Asif ^{[19
]}

Smith, Myles ^{[19
]}

Mazza, Elena ^{[20
]}

Strignano, Paolo ^{[20
]}

Ruurda, Jelle P. ^{[1
]}

van Hillegersberg, Richard ^{[1
]}

机构：

[1] Univ Utrecht, Univ Med Ctr Utrecht, Utrecht, Netherlands

[2] Johannes Gutenberg Univ Mainz, Univ Med Ctr, Mainz, Germany

[3] ZGTAlmelo, Almelo, Netherlands

[4] Chang Gung Univ, Chang Gung Mem Hosp Linko, Taoyuan, Taiwan

[5] Univ Cologne, Cologne, Germany

[6] Univ Pittsburgh, Med Ctr, Pittsburgh, PA USA

[7] Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands

[8] Chinese Univ Hong Kong, Fac Med, Dept Surg, Div Upper GI & Metab Surg, Hong Kong, Peoples R China

[9] Montpellier Canc Inst, Montpellier, France

[10] Univ Klinikum Munster, Munster, Germany

[11] Univ Sao Paulo, Sao Paulo, Brazil

[12] Univ Klinikum Kiel, Kiel, Germany

[13] Univ Hosp Magdeburg, Magdeburg, Germany

[14] Univ Amsterdam, Amsterdam UMC Canc Ctr Amsterdam, Amsterdam, Netherlands

[15] Univ Hosp Eppendorf, Hamburg, Germany

[16] Virginia Mason Hosp, Seattle, WA USA

[17] Charite Univ Med Berlin, Berlin, Germany

[18] Lancashire Teaching Hosp, Preston, Lancs, England

[19] Royal Marsden, London, England

[20] Univ Torino, Citta Salute & Sci, Turin, Italy

来源：

ANNALS OF SURGERY | 2022年 / 276卷 / 05期

关键词：

esophagectomy; minimally invasive surgery; RAMIE; robotics; SHORT-TERM OUTCOMES; LEARNING-CURVE; TRANSTHORACIC ESOPHAGECTOMY; POSTOPERATIVE OUTCOMES; CANCER; RESECTION; ADENOCARCINOMA;

D O I：

10.1097/SLA.0000000000004550

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Objective: This international multicenter study by the Upper GI International Robotic Association aimed to gain insight in current techniques and outcomes of RAMIE worldwide. Background: Current evidence for RAMIE originates from single-center studies, which may not be generalizable to the international multicenter experience. Methods: Twenty centers from Europe, Asia, North-America, and South-America participated from 2016 to 2019. Main endpoints included the surgical techniques, clinical outcomes, and early oncological results of ramie. Results: A total of 856 patients undergoing transthoracic RAMIE were included. Robotic surgery was applied for both the thoracic and abdominal phase (45%), only the thoracic phase (49%), or only the abdominal phase (6%). In most cases, the mediastinal lymphadenectomy included the low paraesophageal nodes (n=815, 95%), subcarinal nodes (n = 774, 90%), and paratracheal nodes (n = 537, 63%). When paratracheal lymphadenectomy was performed during an Ivor Lewis or a McKeown RAMIE procedure, recurrent laryngeal nerve injury occurred in 3% and 11% of patients, respectively. Circular stapled (52%), hand-sewn (30%), and linear stapled (18%) anastomotic techniques were used. In Ivor Lewis RAMIE, robot-assisted hand-sewing showed the highest anastomotic leakage rate (33%), while lower rates were observed with circular stapling (17%) and linear stapling (15%). In McKeown RAMIE, a hand-sewn anastomotic technique showed the highest leakage rate (27%), followed by linear stapling (18%) and circular stapling (6%). Conclusion: This study is the first to provide an overview of the current techniques and outcomes of transthoracic RAMIE worldwide. Although these results indicate high quality of the procedure, the optimal approach should be further defined.

引用

页码：E386 / E392

页数：7

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