505. OUTCOMES AFTER ROBOT-ASSISTED MINIMALLY INVASIVE ESOPHAGECTOMY: REVIEW OF 1000 PATIENTS IN A SINGLE CENTER

Abstract

Abstract Robot-assisted minimally invasive esophagectomy (RAMIE), an increasingly adopted surgical approach, has been demonstrated with higher surgical efficiency and better lymph node dissection than thoracoscopic minimally invasive esophagectomy (MIE) in the Phase III RAMIE trial. We present the safety and feasibility of RAMIE for the surgical treatment in a large group of patients. We reviewed 1000 consecutive patients undergoing RAMIE between November 2015 to March 2022 in our institution. Demographic data, intraoperative parameters, and postoperative outcomes including length of hospital stay, morbidity and mortality were assessed. The primary endpoint of the study was operative (30-day) mortality. Squamous cell carcinoma accounted for 93.8% of all diseases. Most tumors were located in the mid-thoracic esophagus (46.3%) and clinically staged as T2 and T3 (87.4%). The proportion of preoperative therapy was 33.4% All patients received total robot-assisted thoracoscopic-laparoscopic esophagectomy, except for 49 planned hybrid surgery (thoracoscopy or laparotomy). The rate of conversion to open surgery was 3.2% and R0 resection was 96.8%. Overall postoperative complications occurred in 45.2% of patients (C-D grade III: 10.3%) including pulmonary complications (8.6%), anastomotic leakage (8.2%), and vocal cord paralysis (22.4%). Median length of hospital stay was 11 days and 30-day mortality was 0.5%. RAMIE resulted in acceptable surgical results, postoperative outcomes and low mortality, which can be performed safely with good results in an experienced center.