論文

国際誌
2020年9月5日

Lower Incidence of Postoperative Pulmonary Complications Following Robot-Assisted Minimally Invasive Esophagectomy for Esophageal Cancer: Propensity Score-Matched Comparison to Conventional Minimally Invasive Esophagectomy.

Annals of surgical oncology
  • Shigeru Tsunoda
  • ,
  • Kazutaka Obama
  • ,
  • Shigeo Hisamori
  • ,
  • Tatsuto Nishigori
  • ,
  • Ryosuke Okamura
  • ,
  • Hisatsugu Maekawa
  • ,
  • Yoshiharu Sakai

28
2
開始ページ
639
終了ページ
647
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1245/s10434-020-09081-6

BACKGROUND: Whether robot-assisted minimally invasive surgery (RAMIE) is more beneficial than conventional minimally invasive surgery (MIE) remains unclear. METHODS: In total, 165 consecutive patients with esophageal carcinoma who underwent esophagectomy between January 2015 and April 2020 were retrospectively assessed. A 1:1 propensity score matching analysis was performed to compare the short-term outcomes between RAMIE and conventional MIE. RESULTS: After matching, 45 patients were included in the RAMIE and conventional MIE groups. RAMIE had a significantly longer total operative time (708 vs. 612 min, P < 0.001) and thoracic operative time (348 vs. 285 min, P < 0.001) than conventional MIE. However, there were no significant differences in terms of oncological outcomes, such as R0 resection rate and number of resected lymph nodes. The overall postoperative morbidity (Clavien-Dindo [C-D] grade II or higher) rate of RAMIE and conventional MIE were 51% and 73% (P = 0.03), respectively, and the severe postoperative morbidity (C-D grade III or higher) rates were 11% and 29% (P = 0.04), respectively. The incidence rate of recurrent laryngeal nerve palsy was halved in RAMIE (7%) compared with conventional MIE (20%) (P = 0.06). Finally, the pulmonary complication rate (18%) was significantly lower in patients who underwent RAMIE than in those who underwent conventional MIE (44%) (P = 0.006). CONCLUSIONS: RAMIE was safe and feasible, even during the early period of its application at a specialized center. Moreover, it may be a promising alternative to conventional MIE, with better short-term outcomes, including significantly lower incidence of pulmonary complications.

リンク情報
DOI
https://doi.org/10.1245/s10434-020-09081-6
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32892268
ID情報
  • DOI : 10.1245/s10434-020-09081-6
  • PubMed ID : 32892268

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