Achieving textbook outcomes with robotic-assisted Ivor Lewis esophagectomy: a single-center experience with 150 consecutive patients.

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Tác giả: Kristopher Attwood, Maureen Brady, Steven N Hochwald, Faisal Jehan, Moshim Kukar

Ngôn ngữ: eng

Ký hiệu phân loại: 373.236 Lower level

Thông tin xuất bản: Netherlands : Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 555821

BACKGROUND: With published randomized data, minimally invasive esophagectomy (MIE) has become increasingly popular. However, substantial variability in techniques and outcomes still exists. METHODS: This was a retrospective analysis of 150 consecutive robotic-assisted MIEs (RAMIEs) from a prospectively maintained database from 2020 to 2024 at a single comprehensive cancer center. This study aimed to evaluate the textbook outcome rates after RAMIE. RESULTS: A total of 150 consecutive patients underwent RAMIE from 2020 to 2024. Tumor location included the esophagus in 18 patients, type 1 gastroesophageal junction (GEJ) in 52 patients, type 2 GEJ in 71 patients, and type 3 GEJ in 9 patients. Most patients had clinical stage T3 tumors. Neoadjuvant therapy was used in 85% of the patients. A complete pathologic response was observed in 27% of patients. The median number of lymph nodes retrieved was 21. Anastomotic leak occurred in 2 patients, none of whom required reoperation. The median hospital stay duration was 7 days. The 30- and 90-day mortality rates were 0.7% and 1.3%, respectively. In addition, the 90-day stricture rate after endoscopic dilation was 0.7%. Of note, 90% of patients had a textbook outcome. CONCLUSION: This single-center experience highlights that the combination of a robotic platform and a side-to-side stapled anastomotic technique helps achieve exceptional postoperative outcomes for MIE, with a textbook outcome rate of 90%. With the increasing worldwide adoption of MIE, this seems to be an appropriate time to standardize operative techniques to optimize postoperative outcomes.
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