Robotic-assisted esophageal surgery safe, effective for some patients
Robotic-assisted transhiatal esophagectomy was a safe and effective oncologic surgery in carefully selected patients, according to new research.
The robotic technology used in this procedure, which investigators called RATE, provides surgeons with improved view during surgery and allows them to resect lymph nodes without making additional incisions.
“Very few centers have adopted robots for this procedure because of the technical difficulties and unique skills that are needed by the surgeons and the operating room staff,” Daniel H. Dunn, MD, a retired Allina Health surgeon and study investigator, said in a press release. “But the robotic arms can turn and twist and reach more places than human hands will ever be able to.”
To evaluate RATE outcomes, Dunn and colleagues retrospectively reviewed data on 100 consecutive patients (84% men) who underwent the procedure for either esophageal cancer (n = 98) or a benign condition (n = 2) between March 2007 and December 2014 at the Virginia Piper Cancer Center at Abbott Northwestern Hospital in Minneapolis.
Median procedure time was 4 hours and 24 minutes, median estimated blood loss was 75 mL, median ICU stay was 1 day and median hospital stay was 8 days.
The most common postoperative complications included nonmalignant pleural effusion (38%) and recurrent laryngeal nerve injury (33%). Two percent of patients died within 30 days.
The median number of lymph nodes removed was 17 and surgeons achieved R0 resection in most patients (97.8%).
After a median follow-up of 27.7 months, median progression-free survival was 41 months, and the median overall survival was 54 months. PFS rates were 82% at 1 year (95% CI, 75-89%) and 53% at 3 years (95% CI, 42-62%), and OS rates were 95% at 1 year (95% CI, 91-99%) and 57% at 3 years (95% CI, 46-67%).
“In our experience, for a carefully selected group of patients, RATE is safe and effective for the treatment of resectable [esophageal cancer] with acceptable short-term oncologic outcomes,” Dunn and colleagues concluded. – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.