Robotic-assisted minimally invasive Ivor Lewis esophagectomy within the prospective multicenter German da Vinci Xi registry trial
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Robotic-assisted minimally invasive Ivor Lewis esophagectomy within the prospective multicenter German da Vinci Xi registry trial. / Egberts, Jan-Hendrik; Welsch, Thilo; Merboth, Felix; Korn, Sandra; Praetorius, Christian; Stange, Daniel E; Distler, Marius; Biebl, Matthias; Pratschke, Johann; Nickel, Felix; Müller-Stich, Beat; Perez, Daniel; Izbicki, Jakob R; Becker, Thomas; Weitz, Jürgen.
in: LANGENBECK ARCH SURG, Jahrgang 407, Nr. 4, 06.2022, S. 1-11.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Robotic-assisted minimally invasive Ivor Lewis esophagectomy within the prospective multicenter German da Vinci Xi registry trial
AU - Egberts, Jan-Hendrik
AU - Welsch, Thilo
AU - Merboth, Felix
AU - Korn, Sandra
AU - Praetorius, Christian
AU - Stange, Daniel E
AU - Distler, Marius
AU - Biebl, Matthias
AU - Pratschke, Johann
AU - Nickel, Felix
AU - Müller-Stich, Beat
AU - Perez, Daniel
AU - Izbicki, Jakob R
AU - Becker, Thomas
AU - Weitz, Jürgen
N1 - © 2022. The Author(s).
PY - 2022/6
Y1 - 2022/6
N2 - PURPOSE: Robotic-assisted minimally invasive esophagectomy (RAMIE) has become one standard approach for the operative treatment of esophageal tumors at specialized centers. Here, we report the results of a prospective multicenter registry for standardized RAMIE.METHODS: The German da Vinci Xi registry trial included all consecutive patients who underwent RAMIE at five tertiary university centers between Oct 17, 2017, and Jun 5, 2020. RAMIE was performed according to a standard technique using an intrathoracic circular stapled esophagogastrostomy.RESULTS: A total of 220 patients were included. The median age was 64 years. Total minimally invasive RAMIE was accomplished in 85.9%; hybrid resection with robotic-assisted thoracic approach was accomplished in an additional 11.4%. A circular stapler size of ≥28 mm was used in 84%, and the median blood loss and operative time were 200 (IQR: 80-400) ml and 425 (IQR: 335-527) min, respectively. The rate of anastomotic leakage was 13.2% (n=29), whereas the two centers with >70 cases each had rates of 7.0% and 12.0%. Pneumonia occurred in 19.5% of patients, and the 90-day mortality was 3.6%. Cumulative sum analysis of the operative time indicated the end of the learning curve after 22 cases.CONCLUSIONS: High-quality multicenter registry data confirm that RAMIE is a safe procedure and can be reproduced with acceptable leak rates in a multicenter setting. The learning curve is comparably low for experienced robotic surgeons.
AB - PURPOSE: Robotic-assisted minimally invasive esophagectomy (RAMIE) has become one standard approach for the operative treatment of esophageal tumors at specialized centers. Here, we report the results of a prospective multicenter registry for standardized RAMIE.METHODS: The German da Vinci Xi registry trial included all consecutive patients who underwent RAMIE at five tertiary university centers between Oct 17, 2017, and Jun 5, 2020. RAMIE was performed according to a standard technique using an intrathoracic circular stapled esophagogastrostomy.RESULTS: A total of 220 patients were included. The median age was 64 years. Total minimally invasive RAMIE was accomplished in 85.9%; hybrid resection with robotic-assisted thoracic approach was accomplished in an additional 11.4%. A circular stapler size of ≥28 mm was used in 84%, and the median blood loss and operative time were 200 (IQR: 80-400) ml and 425 (IQR: 335-527) min, respectively. The rate of anastomotic leakage was 13.2% (n=29), whereas the two centers with >70 cases each had rates of 7.0% and 12.0%. Pneumonia occurred in 19.5% of patients, and the 90-day mortality was 3.6%. Cumulative sum analysis of the operative time indicated the end of the learning curve after 22 cases.CONCLUSIONS: High-quality multicenter registry data confirm that RAMIE is a safe procedure and can be reproduced with acceptable leak rates in a multicenter setting. The learning curve is comparably low for experienced robotic surgeons.
KW - Esophageal Neoplasms/pathology
KW - Esophagectomy/methods
KW - Humans
KW - Middle Aged
KW - Minimally Invasive Surgical Procedures/methods
KW - Prospective Studies
KW - Registries
KW - Robotic Surgical Procedures/methods
U2 - 10.1007/s00423-022-02520-w
DO - 10.1007/s00423-022-02520-w
M3 - SCORING: Journal article
C2 - 35501604
VL - 407
SP - 1
EP - 11
JO - LANGENBECK ARCH SURG
JF - LANGENBECK ARCH SURG
SN - 1435-2443
IS - 4
ER -