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. 2021 Jan;25(1):1-8.
doi: 10.1007/s11605-019-04510-8. Epub 2020 Feb 18.

Robot-Assisted Minimally Invasive Esophagectomy with Intrathoracic Anastomosis (Ivor Lewis): Promising Results in 100 Consecutive Patients (the European Experience)

Pieter Christiaan van der Sluis #  1 , Evangelos Tagkalos #  1 , Edin Hadzijusufovic  1 , Benjamin Babic  1 , Eren Uzun  1 , Richard van Hillegersberg  2 , Hauke Lang  1   2 , Peter Philipp Grimminger  3
Affiliations

Robot-Assisted Minimally Invasive Esophagectomy with Intrathoracic Anastomosis (Ivor Lewis): Promising Results in 100 Consecutive Patients (the European Experience)

Pieter Christiaan van der Sluis et al. J Gastrointest Surg. 2021 Jan.

Abstract

Background: Robot-assisted minimally invasive esophagectomy (RAMIE) with intrathoracic anastomosis is gaining popularity as a treatment for esophageal cancer. The aim of this study was to describe postoperative complications and short-term oncologic outcomes for RAMIE procedures using the da Vinci Xi robotic system 4-arm technique.

Methods: Data of 100 consecutive patients with esophageal or gastro-esophageal junction carcinoma undergoing modified Ivor Lewis esophagectomy were prospectively collected. All operations were performed by the same surgeon using an identical intrathoracic anastomotic reconstruction technique with the same perioperative management. Intraoperative and postoperative complications were graded according to Esophagectomy Complications Consensus Group (ECCG) definitions.

Results: Mean duration was 416 min (±80); 70% of patients had an uncomplicated postoperative recovery. Pulmonary complications were observed in 17% of patients. Anastomotic leakage was observed in 8% of patients. Median ICU stay was 1 day and median overall postoperative hospital stay was 11 days. The 30-day mortality was 1%; 90-day mortality was 3%. A R0 resection was reached in 92% of patients with a median number of 29 dissected lymph nodes. All patients had at least 7 months of follow-up with a median follow-up of 17 months. Median overall survival was not reached yet.

Conclusion: RAMIE with intrathoracic anastomosis (Ivor Lewis) for esophageal or gastro-esophageal junction cancer was technically feasible and safe. Postoperative complications and short-term oncologic results were comparable to the highest international standards nowadays.

Keywords: Esophageal cancer; Ivor Lewis; MIE; Minimally invasive; RAMIE.

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Conflict of interest statement

P.P. Grimminger and R. van Hillegersberg are proctors for Intuitive Surgical Inc. All other authors have no conflict of interest.

As per the guidelines of the International Committee of Medical Journal Editors (ICMJE), all authors met all of the following criteria

  1. Substantial contributions to the conception or design of the work or the acquisition, analysis, or interpretation of data for the work

  2. Drafting the work or revising it critically for important intellectual content

  3. Final approval of the version to be published

  4. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved

Figures

Fig. 1
Fig. 1
Overall survival for RAMIE (Ivor Lewis). All patients had at least 7 months follow-up. Median follow-up was 17 months; median overall survival was not reached yet
See this image and copyright information in PMC

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