Robot-assisted minimally invasive esophagectomy versus open esophagectomy for esophageal Cancer: A systematic review and meta-analysis Review


Authors: Esagian, S. M.; Ziogas, I. A.; Skarentzos, K.; Katsaros, I.; Tsoulfas, G.; Molena, D.; Karamouzis, M. V.; Rouvelas, I.; Nilsson, M.; Schizas, D.
Review Title: Robot-assisted minimally invasive esophagectomy versus open esophagectomy for esophageal Cancer: A systematic review and meta-analysis
Abstract: Robot-assisted minimally invasive esophagectomy (RAMIE) was introduced as a further development of the conventional minimally invasive esophagectomy, aiming to further improve the high morbidity and mortality associated with open esophagectomy. We aimed to compare the outcomes between RAMIE and open esophagectomy, which remains a popular approach for resectable esophageal cancer. Ten studies meeting our inclusion criteria were identified, including five retrospective cohort, four prospective cohort, and one randomized controlled trial. RAMIE was associated with significantly lower rates of overall pulmonary complications (odds ratio (OR): 0.38, 95% confidence interval (CI): [0.26, 0.56]), pneumonia (OR: 0.39, 95% CI: [0.26, 0.57]), atrial fibrillation (OR: 0.53, 95% CI: [0.29, 0.98]), and wound infections (OR: 0.20, 95% CI: [0.07, 0.57]) and resulted in less blood loss (weighted mean difference (WMD): −187.08 mL, 95% CI: [−283.81, −90.35]) and shorter hospital stays (WMD: −9.22 days, 95% CI: [−14.39, −4.06]) but longer operative times (WMD: 69.45 min, 95% CI: [34.39, 104.42]). No other statistically significant difference was observed regarding surgical and short-term oncological outcomes. Similar findings were observed when comparing totally robotic procedures only to OE. RAMIE is a safe and feasible procedure, resulting in decreased cardiopulmonary morbidity, wound infections, blood loss, and shorter hospital stays compared to open esophagectomy. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
Keywords: cancer surgery; review; outcome assessment; morbidity; pneumonia; hospitalization; feasibility study; systematic review; cardiovascular disease; operation duration; patient safety; surgical infection; intermethod comparison; postoperative hemorrhage; esophagus cancer; atrial fibrillation; meta analysis; randomized controlled trial (topic); comparative effectiveness; minimally invasive esophagectomy; open surgery; human; robot assisted surgery; robotic esophagectomy; open esophagectomy; ramie; robot-assisted minimally invasive esophagectomy; robot assisted minimally invasive esophagectomy
Journal Title: Cancers
Volume: 14
Issue: 13
ISSN: 2072-6694
Publisher: MDPI  
Date Published: 2022-07-01
Start Page: 3177
Language: English
DOI: 10.3390/cancers14133177
PROVIDER: scopus
PMCID: PMC9264782
PUBMED: 35804949
DOI/URL:
Notes: Review -- Export Date: 1 August 2022 -- Source: Scopus
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  1. Daniela   Molena
    272 Molena