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Long-term outcomes after robotic-assisted Ivor Lewis esophagectomy

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Abstract

Robotic assistance has gained acceptance in thoracic procedures, including esophagectomy. There is a paucity of data regarding long-term outcomes for robotic esophagectomy. We previously reported our initial series of robot-assisted Ivor Lewis (RAIL) esophagectomy. We report long-term outcomes to assess the efficacy of the procedure. We performed a retrospective review of 112 consecutive patients who underwent a RAIL. Patient demographics, diagnosis, pathology, operative characteristics, post-operative complications, and long-term outcomes were documented. Descriptive statistical analysis was performed for all the variables. Primary endpoints were mortality and disease-free survival. Overall survival (OS) and disease-free survival (DFS) were calculated using the Kaplan–Meier method. Of the 112 patients, 106 had a diagnosis of cancer, with adenocarcinoma the dominant histology (87.5%). Of these 106 patients, 81 (76.4%) received neo-adjuvant chemoradiation. The 30-, 60-, and 90-day mortality was 1 (0.9%), 3 (2.7%), and 4 (3.6%), respectively. There were 9 anastomotic leaks (8%) and 18 (16.1%) patients had a stricture requiring dilation. All-patient OS at 1, 3, and 5 years was 81.4%, 60.5%, and 51.0%, respectively. For cancer patients, the 1-, 3-, and 5-year OS was 81.3%, 59.2%, and 49.4%, respectively, and the DFS was 75.3%, 42.3%, and 44.0%. We have shown that long-term outcomes after RAIL esophagectomy are similar to other non-robotic esophagectomies. Given the potential advantages of robotic assistance, our results are crucial to demonstrate that RAIL does not result in inferior outcomes.

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Authors and Affiliations

  1. Department of Surgery and Division of Thoracic Surgery, Henry Ford Health System/Wayne State University, 2799 W. Grand Blvd., Detroit, MI, 48202, USA

    Pridvi Kandagatla, Ali Hussein Ghandour, Ali Amro, Andrew Popoff & Zane Hammoud

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  1. Pridvi Kandagatla
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  2. Ali Hussein Ghandour
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  3. Ali Amro
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  4. Andrew Popoff
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  5. Zane Hammoud
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Correspondence to Zane Hammoud.

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Conflicts of interest

Author P. Kandagatla, author A. Ghandour, author A. Amro, and author A. Popoff declare that they have no conflict of interest.

Disclosures

Dr. Zane Hammoud is a proctor for Intuitive Surgical, Inc. and a consultant for Ethicon, Inc.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was waived by our Institutional Review Board due to the retrospective nature of the work (no patients were contacted for this study).

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Kandagatla, P., Ghandour, A.H., Amro, A. et al. Long-term outcomes after robotic-assisted Ivor Lewis esophagectomy. J Robotic Surg 16, 119–125 (2022). https://doi.org/10.1007/s11701-021-01219-2

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  • DOI: https://doi.org/10.1007/s11701-021-01219-2

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