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Program

WSU Medical School

Training Level

Medical Student

Institution

Wayne State University

Abstract

Purpose: Robotic assistance has gained a measure of acceptance in thoracic procedures, including esophagectomy. However, there is a paucity of data regarding long-term outcomes for robotic esophagectomy. We have previously reported our initial series of robot assisted Ivor-Lewis (RAIL) esophagectomy. We report long-term outcomes to assess the efficacy of the procedure.Methods : We performed a retrospective review of 112 consecutive patients who underwent a RAIL at our institution. Patient demographics, diagnosis, pathology, operative characteristics, post-operative complications, and long-term outcomes were documented. Descriptive statistical analysis was performed for all the variables. Primary endpoints were mortality and disease-free survival. Overall survival (OS) and disease-free survival (DFS) were calculated using the Kaplan-Meier method. Results: Of the 112 patients, 106 had a diagnosis of cancer, with adenocarcinoma the dominant histology (87.5%). Of the 106 cancer patients, 81(76.4%) received neo-adjuvant chemoradiation (stage 3A most common). The 30, 60, and 90-day mortality was 1 (0.9%), 3 (2.7%), and 4 (3.6%) respectively. There were 9 anastomotic leaks (8%) and 18 (16.1%) patients had a stricture requiring dilation. All patient OS at 1, 3, and 5 years was 81.4%, 60.5%, and 51.0%, respectively. For cancer patients, the 1, 3, and 5 years OS was 81.3%, 59.2%, and 49.4% respectively and the DFS was 75.3%, 42.3%, and 44.0%. Conclusion: We have shown that long term outcomes after RAIL esophagectomy are similar to other non-robotic esophagectomies. Given the potential advantages of robotic assistance, our results are crucial to demonstrate that RAIL does not result in inferior outcomes.

Publication Date

5-2019

Long-Term Outcomes after Robotic-Assisted Ivor-Lewis Esophagectomy

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