He Haiqi, Wu Qifei, Wang Zhe, Zhang Yong, Chen Nanzheng, Fu Junke, Zhang Guangjian
Department of thoracic surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, China.
J Cardiothorac Surg. 2018 May 23;13(1):52. doi: 10.1186/s13019-018-0727-4.
Minimally invasive esophagectomy (MIE) was shown to be effective in reducing the morbidity and was adopted increasingly. The robot-assisted minimally invasive esophagectomy (RAMIE) remains in the initial stage of application. This study evaluated its safety and feasibility by comparing short-term outcomes of RAMIE and video-assisted minimally invasive esophagectomy (VAMIE).
Between March 2016 and December 2017, 115 consecutive patients underwent RAMIE or VAMIE at our institute. The baseline characteristics, pathological data and short-term outcomes of these two group patients were collected and compared. RAMIE patients were propensity score matched with VAMIE patients for a more accurate comparison.
Matching based on propensity scores produced 27 patients in each group. After propensity score matching (PSM), the baseline characteristics between the two groups were comparable. The operation time in RAMIE group was significantly longer than that in VAMIE group (349 and 294 min, respectively; P < 0.001). The blood loss volume in RAMIE group was less than that in VAMIE group (119 and 158 ml, respectively), but with no statistically significant difference (P = 0.062). There was no significant difference between the two groups with respect to the mean number of dissected lymph nodes (20 and 19, respectively; P = 0.420), postoperative hospital stay (13.8 and 12.7 days, respectively; P = 0.548), the rate of overall complications (37.0 and 33.3%, respectively; P = 0.776) and the rates of detailed complications between the two groups.
The short-term outcomes of RAMIE is comparable to VAMIE, demonstrating safety and feasibility of RAMIE.
微创食管切除术(MIE)已被证明在降低发病率方面有效,并越来越多地被采用。机器人辅助微创食管切除术(RAMIE)仍处于应用初期。本研究通过比较RAMIE和电视辅助微创食管切除术(VAMIE)的短期结果来评估其安全性和可行性。
2016年3月至2017年12月期间,115例连续患者在我院接受了RAMIE或VAMIE手术。收集并比较这两组患者的基线特征、病理数据和短期结果。为了进行更准确的比较,对RAMIE患者与VAMIE患者进行倾向评分匹配。
基于倾向评分匹配后,每组有27例患者。倾向评分匹配(PSM)后,两组之间的基线特征具有可比性。RAMIE组的手术时间明显长于VAMIE组(分别为349分钟和294分钟;P<0.001)。RAMIE组的失血量少于VAMIE组(分别为119毫升和158毫升),但差异无统计学意义(P = 0.062)。两组之间在平均清扫淋巴结数量(分别为20个和19个;P = 0.420)、术后住院时间(分别为13.8天和12.7天;P = 0.548)、总体并发症发生率(分别为37.0%和33.3%;P = 0.776)以及两组之间详细并发症发生率方面均无显著差异。
RAMIE的短期结果与VAMIE相当,证明了RAMIE的安全性和可行性。