Robot assisted minimally invasive esophagectomy: safety, perioperative morbidity and short-term oncological outcome-a single institution experience.

Abstract

Robot assisted minimally invasive esophagectomy (RAMIE) has evolved over the past decade to become procedure of choice at many centers all over the world. The objective of this study is to present our experience of robot assisted minimally invasive esophagectomy with respect to perioperative morbidity and short-term oncological outcomes and a comparison of the same to a cohort of our patients who underwent open Mckeown's esophagectomy. This is a retrospective analysis of prospectively collected data of patients from October 2011 to October 2019. A total of 56 patients in open group and 58 patients in robotic group were enrolled. Upper and middle third was the most common site for open esophagectomy while middle and lower third was more common site for robotic esophagectomy (p < 0.0001). Median operative time was 340min for open and 360min for robotic esophagectomy (p = 0.004). A median of 16 lymph nodes were retrieved in either group. R0 resection was achieved in 86% in open and 97% in robotic group (p = 0.04). Median intensive care unit (ICU) stay (2days versus 5days) and median hospital stay (10.5days versus 14.5days) were both favoring for robotic group (p < 0.0001). Cardiac arrhythmias and pulmonary complications requiring ICU readmission occurred less frequently in patients undergoing robotic esophagectomy (p = 0.02). Two-year overall survival (p = 0.09) and 2-year disease-free survival (p = 0.32) was similar between the groups. RAMIE significantly reduced ICU as well as hospital stay and had oncological outcome similar to open Mckeown's esophagectomy.