Department of General Surgery, Başakşehir Çam and Sakura City Hospital, Başakşehir, Istanbul, Turkey.
Department of Surgical Oncology, Başakşehir Çam and Sakura City Hospital, Başakşehir, Istanbul, Turkey.
J Cancer Res Ther. 2024 Jan 1;20(1):410-416. doi: 10.4103/jcrt.jcrt_2518_22. Epub 2023 May 3.
Robotic-assisted minimally invasive esophagectomy (RAMIE) is a recently developed technique for the treatment of resectable esophageal cancer. The present study compares the outcomes of RAMIE and video-assisted thoracoscopic esophagectomy (VATE).
Patients undergoing minimally invasive esophageal surgery between December 2020 and September 2022 were included in the study, while those undergoing conventional surgery were excluded. The patients were divided into two groups, as those undergoing RAMIE (Group 1) and those undergoing VATE (Group 2). The demographic and clinical characteristics, intraoperative parameters, pathological data, and postoperative parameters of the groups were compared.
A total of 28 patients were included in the study, with 13 patients in Group 1 and 15 patients in Group 2. The gender distribution was similar (P = 0.488), and the mean age was 64.7 and 59.0 years in Groups 1 and 2, respectively (P = 0.068). The majority of the sample was in the ASA2 category (46.2% vs. 66.7%, P = 0.341); Ca19.9 levels were higher in Group 1 than in Group 2 (25.7 vs. 13.7, P = 0.027); preoperative Hb was lower in Group 1 than in Group 2 (10.9 g/dL vs. 12.2 g/dL, P = 0.043); the most commonly performed surgery was the McKeown procedure (69.2% vs. 66.7%, P = 0.492); an intraoperative feeding jejunostomy was placed only in Group 2; the operation time was similar between the groups (338.5 min vs. 340 min, P = 0.916); and the distribution of tumor localizations was similar between the groups (P = 0.407). In terms of tumor histology, squamous cell carcinoma (SCC) was the most common tumor type in the two groups (84.6% vs. 80%, P = 0.636); the tumor diameter was similar between the groups (14.9 vs. 18.1, P = 0.652); the number of removed lymph nodes was similar between the groups (24.9 vs. 22.5, P = 0.419); and the number of metastatic lymph nodes was higher in Group 2 (0.08 vs. 1.07, P = 0.27). One patient in Group 2 underwent repeat surgery due to suspected ischemic anastomosis; the distribution of postoperative complications according to the Clavien-Dindo classification system was similar in the two groups (P = 0.650); there was no early mortality within the first 30 days in either group; one patient in Group 2 was re-admitted within 90 days of discharge with decreased oral intake; the length of hospital stay was shorter in Group 1 (9 days vs. 16.5 days, P = 0.006); and the patients in Group 2 more often received neoadjuvant therapy in proportion to the disease stage (15.4% vs. 60%, P = 0.016).
Robotic procedures can be safely performed in esophageal cancers with complication rates and oncological radicality similar to those of other minimally invasive techniques.
简介：机器人辅助微创食管切除术（RAMIE）是一种最近开发的治疗可切除食管癌的技术。本研究比较了 RAMIE 和电视辅助胸腔镜食管切除术（VATE）的结果。
方法：纳入 2020 年 12 月至 2022 年 9 月期间接受微创食管手术的患者，排除接受常规手术的患者。患者分为两组，一组行 RAMIE（组 1），另一组行 VATE（组 2）。比较两组的人口统计学和临床特征、术中参数、病理数据和术后参数。
结果：共纳入 28 例患者，组 1 13 例，组 2 15 例。性别分布无差异（P = 0.488），年龄分别为 64.7 岁和 59.0 岁（P = 0.068）。大多数样本为 ASA2 类别（46.2%比 66.7%，P = 0.341）；组 1 的 Ca19.9 水平高于组 2（25.7 比 13.7，P = 0.027）；组 1 的术前 Hb 水平低于组 2（10.9 比 12.2，P = 0.043）；最常进行的手术是 McKeown 手术（69.2%比 66.7%，P = 0.492）；仅在组 2 中进行术中喂养空肠造口术；两组的手术时间相似（338.5 分钟比 340 分钟，P = 0.916）；两组肿瘤定位分布相似（P = 0.407）。在肿瘤组织学方面，两组最常见的肿瘤类型均为鳞状细胞癌（SCC）（84.6%比 80%，P = 0.636）；肿瘤直径无差异（14.9 比 18.1，P = 0.652）；两组淋巴结清扫数相似（24.9 比 22.5，P = 0.419）；组 2 的转移淋巴结数更高（0.08 比 1.07，P = 0.27）。组 2 中有 1 例患者因疑似吻合口缺血而行再次手术；两组术后并发症的 Clavien-Dindo 分类系统分布相似（P = 0.650）；两组均无 30 天内早期死亡；组 2 中有 1 例患者在出院后 90 天内因口服摄入量减少而再次入院；组 1 的住院时间较短（9 天比 16.5 天，P = 0.006）；组 2 中更多的患者根据疾病阶段接受新辅助治疗（15.4%比 60%，P = 0.016）。
结论：机器人手术可安全应用于食管癌，其并发症发生率和肿瘤根治性与其他微创技术相似。
