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降低食管切除术风险:杂交手术与全机器人辅助微创食管切除术(RAMIE)方法的回顾性比较

Reducing the Risks of Esophagectomies: A Retrospective Comparison of Hybrid versus Full-Robotic-Assisted Minimally Invasive Esophagectomy (RAMIE) Approaches.

作者信息

Hoelzen Jens Peter, Frankauer Brooke E, Szardenings Carsten, Roy Dhruvajyoti, Pollmann Lukas, Fortmann Lukas, Merten Jennifer, Rijcken Emile, Juratli Mazen A, Pascher Andreas

机构信息

Department of General, Visceral and Transplant Surgery, University Hospital Muenster, 48149 Muenster, Germany.

Institute of Biostatistics and Clinical Research, University of Muenster, 48149 Muenster, Germany.

出版信息

J Clin Med. 2023 Sep 7;12(18):5823. doi: 10.3390/jcm12185823.

Abstract

This retrospective analysis aimed to assess and compare the short-term perioperative outcomes and morbidity of hybrid and full-Robotic-Assisted Minimally Invasive Esophagectomy (RAMIE) surgical techniques. A total of 168 robotic-assisted Ivor Lewis esophagectomy procedures performed at Muenster University Hospital were included in the study, with 63 cases in the hybrid group and 105 cases in the full-robotic group. Demographic factors, comorbidities, and tumor stages showed no significant differences between the two groups. However, the full-RAMIE technique demonstrated superiority in terms of overall operative time, postoperative pain levels, and patient morphine consumption. Additionally, the full-RAMIE group exhibited better perioperative outcomes, with significantly shorter ICU stays and fewer occurrences of pneumonias and severe complications. While there was a trend favoring the full-RAMIE technique in terms of severe postoperative complications and anastomotic insufficiencies, further research is required to establish it as the gold standard surgical technique for Ivor Lewis esophagectomy.

摘要

本回顾性分析旨在评估和比较杂交式与全机器人辅助微创食管切除术(RAMIE)手术技术的短期围手术期结局及发病率。明斯特大学医院共进行了168例机器人辅助的艾弗·刘易斯食管切除术,其中杂交组63例,全机器人组105例。两组在人口统计学因素、合并症和肿瘤分期方面无显著差异。然而,全RAMIE技术在总手术时间、术后疼痛程度和患者吗啡用量方面表现出优势。此外,全RAMIE组围手术期结局更好,ICU住院时间显著缩短,肺炎和严重并发症的发生率更低。虽然在严重术后并发症和吻合口漏方面有倾向于全RAMIE技术的趋势,但需要进一步研究以确立其作为艾弗·刘易斯食管切除术的金标准手术技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7eb5/10531670/93ea6f67be34/jcm-12-05823-g001.jpg

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