Surgical Endoscopy

, Volume 27, Issue 9, pp 3339–3347

Initial experience from a large referral center with robotic-assisted Ivor Lewis esophagogastrectomy for oncologic purposes

  • Sebastian G. de la Fuente
  • Jill Weber
  • Sarah E. Hoffe
  • Ravi Shridhar
  • Richard Karl
  • Kenneth L. Meredith
Article

Abstract

Background

We report our initial experience of patients undergoing robotic-assisted Ivor Lewis esophagogastrectomy (RAIL) for oncologic purposes at a large-referral center.

Methods

A retrospective review of all consecutive patients undergoing RAIL from 2010–2011 was performed. Basic demographics were recorded. Oncologic variables recorded included: tumor type, location, postoperative tumor margins, and nodal harvest. Immediate 30-day postoperative complications also were analyzed.

Results

Fifty patients underwent RAIL with median age of 66 (range 42–82) years. The mean body mass index was 28.6 ± 0.7 kg/m2; 54 % and the majority had an American Society of Anesthesiologists classification of 3. The mean and median number of lymph nodes retrieved during surgery was 20 ± 1.4 and 18.5 respectively. R0 resections were achieved in all patients. Postoperative complications occurred in 14 (28 %) patients, including atrial fibrillation in 5 (10 %), pneumonia in 5 (10 %), anastomotic leak in 1 (2 %), conduit staple line leak in 1 (2 %), and chyle leak in 2 (4 %). The median ICU stay and length of hospitalization (LOH) were 2 and 9 days respectively. Total mean operating time calculated from time of skin incision to wound closure was 445 ± 85 minutes; however, operative times decreased over time. Similarly, there was a trend toward lower complications after the first 29 cases but this did not reach statistical significance. There were no in-hospital mortalities.

Conclusions

We demonstrated that RAIL for esophageal cancer can be performed safely and may be associated with fewer complications after a learning curve, shorter ICU stay, and LOH.

Keywords

Oesophageal Cancer Oesophageal GI 

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Sebastian G. de la Fuente
    • 1
  • Jill Weber
    • 2
  • Sarah E. Hoffe
    • 2
  • Ravi Shridhar
    • 2
  • Richard Karl
    • 2
  • Kenneth L. Meredith
    • 2
  1. 1.Division of Surgical OncologyFlorida Hospital Orlando, University of Central FloridaOrlandoUSA
  2. 2.Department of Gastrointestinal OncologyH. Lee Moffitt Cancer CenterTampaUSA

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