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September 10, 2025

Robotic-Assisted Minimally Invasive, Open, and Conventional Minimally Invasive Esophagectomy for Esophageal Carcinoma—comprehensive Quantitative Analysis of Perioperative Outcomes and Survival

Key Points

Robotic-assisted minimally invasive esophagectomy significantly reduces pulmonary complications compared to open esophagectomy.
Among 10,127 patients, RAMIE led to shorter ICU stays, although operative times were longer for robotic procedures.
Data extraction used PRISMA guidelines and Newcastle-Ottawa Scale for quality assessment across 50 studies.
RAMIE shows comparable long-term survival to traditional methods, highlighting its safety and feasibility for esophageal carcinoma.

Abstract

Abstract Background Robotic-assisted minimally invasive esophagectomy (RAMIE) has emerged as a promising alternative for esophageal carcinoma (EC). This quantitative analysis evaluates perioperative and long-term outcomes of RAMIE versus open esophagectomy (OE) and minimally invasive esophagectomy (MIE). Methods Following PRISMA guidelines, databases including PubMed, Web of Science, Cochrane Library, and Embase were queried for studies on perioperative and long-term outcomes of RAMIE, OE, and MIE for EC up to June 1, 2024. Data extraction and quality assessment were performed using the Newcastle-Ottawa Scale (NOS) and the Cochrane Collaboration’s Risk of Bias Tool. Fixed-effects or random-effects models pooled ORs, HRs, MD, and their 95% CI based on heterogeneity. Results Fifty studies comprising 10,127 patients were included. Compared to OE, RAMIE significantly reduced pulmonary complications, gastric retention, cardiovascular complications, and wound infections, despite longer operative times. Compared to MIE, RAMIE had more abdominal and left recurrent laryngeal nerve lymph node dissections, lower rates of postoperative pulmonary complications, anastomotic leakage, gastric retention, and recurrent laryngeal nerve injury, but longer operative times. RAMIE patients had shorter ICU stays than the both traditional surgical methods. There were no significant differences in long-term overall survival and disease-free survival between RAMIE, OE, and MIE. Conclusion RAMIE shows favorable perioperative outcomes and reduced postoperative complications compared to OE and MIE, with comparable long-term survival. Despite longer operative times, RAMIE is safe and feasible for EC patients. Future research should focus on optimizing surgical time and conducting randomized controlled trials to confirm its benefits, guiding clinical decision-making and optimizing patient care.

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Cite This Study

Yuan et al. (Fri,) studied this question.

synapsesocial.com/papers/68c195559b7b07f3a0618eda https://doi.org/https://doi.org/10.1093/dote/doaf061.341

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