Universität zu Köln

Grimminger, Peter P., Staubitz, Julia, I, Perez, Daniel ORCID: 0000-0002-3154-7311, Ghadban, Tarik, Reeh, Matthias, Scognamiglio, Pasquale, Izbicki, Jakob R., Biebl, Matthias ORCID: 0000-0002-3690-8614, Fuchs, Hans, Bruns, Christiane J., Lang, Hauke, Becker, Thomas and Egberts, Jan-Hendrik (2021). Multicenter Experience in Robot-Assisted Minimally Invasive Esophagectomy - a Comparison of Hybrid and Totally Robot-Assisted Techniques. J. Gastrointest. Surg., 25 (10). S. 2463 - 2470. NEW YORK: SPRINGER. ISSN 1873-4626

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Abstract

Background Oncological esophageal surgery has evolved significantly in the last decades. From open esophagectomy over (hybrid) minimally invasive surgery, nowadays, robot-assisted minimally invasive esophagectomy (RAMIE) approaches are applied. Current techniques require an analysis of possible advantages and disadvantages indicating the direction towards a novel gold standard. Methods Robot-assisted Ivor Lewis esophagectomies, performed in the period from April 2017 to June 2019 in five German centers (Berlin, Cologne, Hamburg, Kiel, Mainz), were included in this study. Pre-, intra-, and postoperative parameters were assessed. Cases were grouped for hybrid (H-RAMIE) versus totally robot-assisted (T-RAMIE) approaches. Postoperative parameters and complications were compared using risk ratios. Results A total of 175 operations were performed as T-RAMIE and 67 as H-RAMIE. Patient age (median age 62 years) and sex (83.1% male) were similarly distributed in both groups. Median duration of esophagectomy was significantly lower in the T-RAMIE group (385 versus 427 min, p < 0.001). The risks of overall morbidity (32.0 versus 47.8%; risk ratio [RR], 95% confidence interval (CI): 1.5, 1.1-2.1; p = 0.026), anastomotic leak (10.3 versus 22.4%; RR, CI: 2.2, 1.2-4.1; p = 0.020), and respiratory failure (1.1 versus 7.5%; RR, CI: 6.5, 1.3-32.9; p = 0.019) were significantly higher in case of H-RAMIE. Conclusions In the five participating German centers, T-RAMIE was the preferred procedure (72.3% of operations). In comparison to H-RAMIE, T-RAMIE was associated with a significantly reduced risk of postoperative morbidity, anastomotic leak, and respiratory failure as well as a significantly reduced time necessary for esophagectomy.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Grimminger, Peter P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Staubitz, Julia, I UNSPECIFIED UNSPECIFIED UNSPECIFIED Perez, Daniel UNSPECIFIED orcid.org/0000-0002-3154-7311 UNSPECIFIED Ghadban, Tarik UNSPECIFIED UNSPECIFIED UNSPECIFIED Reeh, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Scognamiglio, Pasquale UNSPECIFIED UNSPECIFIED UNSPECIFIED Izbicki, Jakob R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Biebl, Matthias UNSPECIFIED orcid.org/0000-0002-3690-8614 UNSPECIFIED Fuchs, Hans UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, Christiane J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lang, Hauke UNSPECIFIED UNSPECIFIED UNSPECIFIED Becker, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Egberts, Jan-Hendrik UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-596477
DOI:	10.1007/s11605-021-05044-8
Journal or Publication Title:	J. Gastrointest. Surg.
Volume:	25
Number:	10
Page Range:	S. 2463 - 2470
Date:	2021
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1873-4626
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language THORACOSCOPIC ESOPHAGECTOMY; CANCER; OUTCOMES Multiple languages Gastroenterology & Hepatology; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59647