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Early Outcomes of Robot-Assisted Versus Thoracoscopic-Assisted Ivor Lewis Esophagectomy for Esophageal Cancer: A Propensity Score-Matched Study

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Both robot-assisted Ivor Lewis esophagectomy (RAILE) and conventional thoracoscopic-assisted Ivor Lewis esophagectomy (TAILE) are minimally invasive surgical techniques for the treatment of middle and distal esophageal cancer. However, no research studies comparing early outcomes between RAILE and TAILE have been reported.

Methods

A retrospective analysis was made of 184 patients, 76 in the RAILE group and 108 in the TAILE group, who underwent minimally invasive Ivor Lewis esophagectomy between December 2014 and June 2018. Propensity score-matched analysis was performed between the two groups based on demographics, comorbidities, American Society of Anesthesiologists score, tumor location, tumor size, and pathological stage. Perioperative outcomes were compared.

Results

Two conversions to thoracotomy occurred in the RAILE group. There was no 30-day in either group. Sixty-six matched pairs were identified for each group. Within the propensity score-matched cohorts, the operative time in the RAILE group was significantly longer than that in the TAILE group (302.0 ± 62.9 vs. 274.7 ± 38.0 min, P = 0.004). There was no significant difference in the blood loss [200.0 ml (interquartile range [IQR], 100.0–262.5 ml) vs. 200.0 ml (150.0–245.0 ml), P = 0.100], rates of overall complications (28.8 vs. 24.2%, P = 0.554), length of stay [9.0 days (IQR 8.0–12.3 days) vs. 9.0 days (IQR 8.0–11.3 days), P = 0.517], the number of total dissected lymph nodes (19.2 ± 9.2 vs. 19.3 ± 9.5, P = 0.955), and detailed categories of lymph nodes.

Conclusions

RAILE demonstrated comparable early outcomes compared with TAILE and should be considered as an alternative minimally invasive option for treating esophageal cancer.

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Acknowledgment

This work was supported by grants from the Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support (20172005) and the Shanghai Jiao Tong University Cooperation Grant of Medicine, Science and Engineering (YG2015QN39). The authors thank Dr. Maosheng Huang, statistician from the Department of Epidemiology, the University of Texas MD Anderson Cancer Center for review of the manuscript.

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Author notes

  1. Yajie Zhang and Yu Han have contributed equally to this work.

Authors and Affiliations

  1. Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

    Yajie Zhang MD, PhD, Yu Han MD, Qinyi Gan MD, Jie Xiang MD, Runsen Jin MD, PhD, Kai Chen MD, Jiaming Che MD, Junbiao Hang MD & Hecheng Li MD, PhD

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  1. Yajie Zhang MD, PhD
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Correspondence to Hecheng Li MD, PhD.

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Zhang, Y., Han, Y., Gan, Q. et al. Early Outcomes of Robot-Assisted Versus Thoracoscopic-Assisted Ivor Lewis Esophagectomy for Esophageal Cancer: A Propensity Score-Matched Study. Ann Surg Oncol 26, 1284–1291 (2019). https://doi.org/10.1245/s10434-019-07273-3

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  • DOI: https://doi.org/10.1245/s10434-019-07273-3

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