Kenneth Meredith, MD1, Jamie Huston, BS1, Oya Andacoglu, MD2, Pedro Briceno, MD1, Ravi Shridhar, MD, PhD3. 1Florida State University/Sarasota Memorial Healthcare System, 2University of Wisconsin, Madison, 3University of Central Florida
Introduction: Esophagectomy is associated with substantial morbidity. Robotic surgery allows complex resections to be performed with potential benefits over conventional techniques. We applied this technology to transthoracic esophagectomy to assess safety, feasibility, versatility, and reliability of this technology.
Methods: A retrospective review of all patients undergoing robotic assisted Ivor Lewis esophagectomy (RAIL) from 2009-2014 was conducted. Clinicopathologic factors and surgical outcomes were recorded and compared. All statistical tests were two-sided and an α (type I) error <0.05 was considered statistically significant.
Results: We identified 147 patients with an average age 66 ±10 years. Neoadjuvant therapy was administered to 114 (77.6%) patients, and all patients underwent a R0 resection. The mean OR time was 415 ± 84.6 minutes with a median EBL of 150 (25-600) mL. Mean ICU stay was 2.00 ± 4.5 days, median length of stay was 9 (4-38) days and re-admissions were low at 8 (5.5%). OR time decreased from 471 minutes to 389 minutes after 20 cases and a further decrease to mean of 346 minutes was observed after 120 cases. Complications occurred in 37 patients (25.2%). There were 4 anastomotic (2.7%) leaks. Thirty and 90-day mortality was 0.68% and 1.4% respectively.
Conclusion: This represents to our knowledge the largest series of robotic esophagectomies. RAIL is a safe surgical technique that provides an alternative to standard minimally invasive and open techniques. In our series there was no increased risk of LOH, complications, or death and re-admission rates were low despite earlier discharge.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80183
Program Number: P684
Presentation Session: Poster (Non CME)
Presentation Type: Poster