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Background <p>The surgical outcomes of Robotic-Assisted Minimally Invasive Esophagectomy (RAMIE) and Minimally Invasive Ivor Lewis Esophagectomy (MIE) were compared.</p> Methods <p>Retrospective study of adults (≥ 18&#xa0;years) with esophageal cancer who underwent a MIE from December 2014-May 2024. Surgeon skill was measured pre- and post-utilization of RAMIE. Primary outcome was patient mortality. Secondary outcomes were mortality, readmission, and reoperation measured at 30 and 90&#xa0;days, and complications. Risk differences (RD) calculated the difference in outcome between the two groups. Cox regression (CR) was used to estimate the risk of mortality based on type of surgical procedure.</p> Results <p>303 patients, 71 (23.4%) RAMIE and 232 (76.6%) MIE. Proficiency revealed operative times with RAMIE was significantly longer in the early phase (<i>P</i> &lt; 0.001), however, shortened with experience while MIE operative time increased. The 30-day and 90-day mortality were (2.8% vs 4.3% and 10.1% vs 5.9%, with insignificant RD. 30- and 90-day readmissions were (14.1% vs 8.6% and 14.1% vs 11.6%), with insignificant RD. 30- and 90-day reoperations were (2.8% vs 1.7% and 14.1% vs 7.8%), also with insignificant RD. Complications following surgery between RAMIE and MIE were (45.1% vs 48.3%), with an insignificant RD. There was a significant difference in the overall survival curves between the two groups in favor of MIE (<i>P</i> &lt; 0.001).</p> Conclusion <p>Long-term survival was significantly shorter for RAMIE compared to MIE. However, 30- and 90-day mortality, readmission rates and reoperations, and postoperative complications were not significantly different when compared to MIE. Well-designed prospective studies are needed to validate these findings.</p>

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Robotic vs. laparoscopic Ivor Lewis esophagectomy for esophageal cancer: a weighted short- and long-term outcomes analysis

  • 期刊论文

  • 发表日期：

    2026年2月26日

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  • Andres Ramos-Fresnedo,
  • Keouna Pather,
  • Chelsea R. Yap,
  • Brian G. Celso,
  • Erin M. Mobley,
  • Ziad T. Awad

摘要

Background

The surgical outcomes of Robotic-Assisted Minimally Invasive Esophagectomy (RAMIE) and Minimally Invasive Ivor Lewis Esophagectomy (MIE) were compared.

Methods

Retrospective study of adults (≥ 18 years) with esophageal cancer who underwent a MIE from December 2014-May 2024. Surgeon skill was measured pre- and post-utilization of RAMIE. Primary outcome was patient mortality. Secondary outcomes were mortality, readmission, and reoperation measured at 30 and 90 days, and complications. Risk differences (RD) calculated the difference in outcome between the two groups. Cox regression (CR) was used to estimate the risk of mortality based on type of surgical procedure.

Results

303 patients, 71 (23.4%) RAMIE and 232 (76.6%) MIE. Proficiency revealed operative times with RAMIE was significantly longer in the early phase (P < 0.001), however, shortened with experience while MIE operative time increased. The 30-day and 90-day mortality were (2.8% vs 4.3% and 10.1% vs 5.9%, with insignificant RD. 30- and 90-day readmissions were (14.1% vs 8.6% and 14.1% vs 11.6%), with insignificant RD. 30- and 90-day reoperations were (2.8% vs 1.7% and 14.1% vs 7.8%), also with insignificant RD. Complications following surgery between RAMIE and MIE were (45.1% vs 48.3%), with an insignificant RD. There was a significant difference in the overall survival curves between the two groups in favor of MIE (P < 0.001).

Conclusion

Long-term survival was significantly shorter for RAMIE compared to MIE. However, 30- and 90-day mortality, readmission rates and reoperations, and postoperative complications were not significantly different when compared to MIE. Well-designed prospective studies are needed to validate these findings.