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Initial experience from a large referral center with robotic-assisted Ivor Lewis esophagogastrectomy for oncologic purposes

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Abstract

Background

We report our initial experience of patients undergoing robotic-assisted Ivor Lewis esophagogastrectomy (RAIL) for oncologic purposes at a large-referral center.

Methods

A retrospective review of all consecutive patients undergoing RAIL from 2010–2011 was performed. Basic demographics were recorded. Oncologic variables recorded included: tumor type, location, postoperative tumor margins, and nodal harvest. Immediate 30-day postoperative complications also were analyzed.

Results

Fifty patients underwent RAIL with median age of 66 (range 42–82) years. The mean body mass index was 28.6 ± 0.7 kg/m2; 54 % and the majority had an American Society of Anesthesiologists classification of 3. The mean and median number of lymph nodes retrieved during surgery was 20 ± 1.4 and 18.5 respectively. R0 resections were achieved in all patients. Postoperative complications occurred in 14 (28 %) patients, including atrial fibrillation in 5 (10 %), pneumonia in 5 (10 %), anastomotic leak in 1 (2 %), conduit staple line leak in 1 (2 %), and chyle leak in 2 (4 %). The median ICU stay and length of hospitalization (LOH) were 2 and 9 days respectively. Total mean operating time calculated from time of skin incision to wound closure was 445 ± 85 minutes; however, operative times decreased over time. Similarly, there was a trend toward lower complications after the first 29 cases but this did not reach statistical significance. There were no in-hospital mortalities.

Conclusions

We demonstrated that RAIL for esophageal cancer can be performed safely and may be associated with fewer complications after a learning curve, shorter ICU stay, and LOH.

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Disclosures

Drs. Sebastian G. de la Fuente, Jill Weber, Sarah E. Hoffe, Ravi Shridhar, Richard Karl, and Kenneth L. Meredith have no conflict of interest or financial ties to disclose.

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Authors and Affiliations

  1. Division of Surgical Oncology, Florida Hospital Orlando, University of Central Florida, 2415 N. Orange Ave, Suite 400, Orlando, FL, 32804, USA

    Sebastian G. de la Fuente

  2. Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA

    Jill Weber, Sarah E. Hoffe, Ravi Shridhar, Richard Karl & Kenneth L. Meredith

Authors
  1. Sebastian G. de la Fuente
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  2. Jill Weber
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  3. Sarah E. Hoffe
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  4. Ravi Shridhar
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  5. Richard Karl
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  6. Kenneth L. Meredith
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Correspondence to Sebastian G. de la Fuente.

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de la Fuente, S.G., Weber, J., Hoffe, S.E. et al. Initial experience from a large referral center with robotic-assisted Ivor Lewis esophagogastrectomy for oncologic purposes. Surg Endosc 27, 3339–3347 (2013). https://doi.org/10.1007/s00464-013-2915-6

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  • DOI: https://doi.org/10.1007/s00464-013-2915-6

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