Literature DB >> 31026433

Early Quality of Life Outcomes After Robotic-Assisted Minimally Invasive and Open Esophagectomy.

Inderpal S Sarkaria1, Nabil P Rizk2, Debra A Goldman3, Camelia Sima3, Kay See Tan3, Manjit S Bains2, Prasad S Adusumilli2, Daniela Molena2, Matthew Bott2, Thomas Atkinson3, David R Jones2, Valerie W Rusch2.   

Abstract

BACKGROUND: Minimally invasive esophagectomy may improve some perioperative outcomes over open approaches; effects on quality of life are less clear.
METHODS: A prospective trial of robotic-assisted minimally invasive esophagectomy (RAMIE) and open esophagectomy was initiated, measuring quality of life via the Functional Assessment of Cancer Therapy-Esophageal and Brief Pain Inventory. Mixed generalized linear models assessed associations between quality of life scores over time and by surgery type.
RESULTS: In total, 106 patients underwent open esophagectomy; 64 underwent minimally invasive esophagectomy (98% RAMIE). The groups did not differ in age, sex, comorbidities, histologic subtype, stage, or induction treatment (P = .42 to P > .95). Total Functional Assessment of Cancer Therapy-Esophageal scores were lower at 1 month (P < .001), returned to near baseline by 4 months, and did not differ between groups (P = .83). Brief Pain Inventory average pain severity (P = .007) and interference (P = .004) were lower for RAMIE. RAMIE had lower estimated blood loss (250 vs 350 cm3; P < .001), shorter length of stay (9 vs 11 days; P < .001), fewer intensive care unit admissions (8% vs 20%; P = .033), more lymph nodes harvested (25 vs 22; P = .05), and longer surgical time (6.4 vs 5.4 hours; P < .001). Major complications (39% for RAMIE vs 52% for open esophagectomy; P > .95), anastomotic leak (3% vs 9%; P = .41), and 90-day mortality (2% vs 4%; P = .85) did not differ between groups. Pulmonary (14% vs 34%; P = .014) and infectious (17% vs 36%; P = .029) complications were lower for RAMIE.
CONCLUSIONS: RAMIE is associated with lower immediate postoperative pain severity and interference and decreased pulmonary and infectious complications. Ongoing data accrual will assess mid-term and long-term outcomes in this cohort.
Copyright © 2019 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Entities:  

Year:  2019        PMID: 31026433      PMCID: PMC6774254          DOI: 10.1016/j.athoracsur.2018.11.075

Source DB:  PubMed          Journal:  Ann Thorac Surg        ISSN: 0003-4975            Impact factor:   4.330


  27 in total

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Journal:  Pain       Date:  2005-01       Impact factor: 6.961

2.  A propensity-matched analysis comparing survival after primary minimally invasive esophagectomy followed by adjuvant therapy to neoadjuvant therapy for esophagogastric adenocarcinoma.

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3.  Initial experience from a large referral center with robotic-assisted Ivor Lewis esophagogastrectomy for oncologic purposes.

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Review 4.  Robotic-assisted minimally invasive esophagectomy: the Ivor Lewis approach.

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Journal:  Thorac Surg Clin       Date:  2014-05       Impact factor: 1.750

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Authors:  R Parameswaran; A McNair; K N L Avery; R G Berrisford; S A Wajed; M A G Sprangers; J M Blazeby
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8.  Combined thoracoscopic and laparoscopic robotic-assisted minimally invasive esophagectomy using a four-arm platform: experience, technique and cautions during early procedure development.

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Authors:  Mark van Heijl; Mirjam A G Sprangers; Angela G E M de Boer; Sjoerd M Lagarde; Hans B Reitsma; Olivier R C Busch; Hugo W Tilanus; Jan J B van Lanschot; Mark I van Berge Henegouwen
Journal:  Ann Surg Oncol       Date:  2009-10-15       Impact factor: 5.344

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  18 in total

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Review 3.  Health-related quality of life after esophagectomy in patients with esophageal cancer.

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Review 7.  Robot-Assisted Minimally Invasive Esophagectomy versus Open Esophagectomy for Esophageal Cancer: A Systematic Review and Meta-Analysis.

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Review 8.  Current status of robot-assisted minimally invasive esophagectomy: what is the real benefit?

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9.  Robotic-assisted minimally invasive Ivor Lewis esophagectomy within the prospective multicenter German da Vinci Xi registry trial.

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10.  Two-Year Quality of Life Outcomes After Robotic-Assisted Minimally Invasive and Open Esophagectomy.

Authors:  Marc Vimolratana; Inderpal S Sarkaria; Debra A Goldman; Nabil P Rizk; Kay See Tan; Manjit S Bains; Prasad S Adusumilli; Smita Sihag; James M Isbell; James Huang; Bernard J Park; Daniela Molena; Valerie W Rusch; David R Jones; Matthew J Bott
Journal:  Ann Thorac Surg       Date:  2020-11-04       Impact factor: 5.102

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