Efficacy of Da Vinci robot-assisted minimally invasive esophagectomy versus video-assisted minimally invasive esophagectomy: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Gang ^1,2 , ZHANG Jiani ^1,3 , SHEN Xu ¹ , ALAI Guha ^1,4 , XU Zhijie ^1,4 , SONG Tieniu ^1,4 , ZHU Yunke ¹ ,  LIN Yidan ¹

1. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
2. Public Health Clinical Center of Chengdu, Chengdu, 610011, P. R. China;
3. West China School of Nursing, Sichuan University, Chengdu, 610011, P. R. China;
4. West China School of Medicine, Sichuan University, Chengdu, 610041, P. R. China;

Corresponding author：

LIN Yidan, Email: linyidan.academy@foxmail.com

Keywords：

Da Vinci robot-assisted system; thoracoscopic surgery; minimally invasive esophagectomy; esophageal carcinoma; systematic review/meta-analysis

DOI：

10.7507/1007-4848.202009098

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To compare the surgical efficacy of Da Vinci robot-assisted minimally invasive esophagectomy (RAMIE) and video-assisted minimally invasive esophagectomy (VAMIE) on esophageal cancer.Methods Online databases including PubMed, the Cochrane Library, Medline, EMbase and CNKI from inception to 31, December 2019 were searched by two researchers independently to collect the literature comparing the clinical efficacy of RAMIE and VAMIE on esophageal cancer. Newcastle-Ottawa Scale was used to assess quality of the literature. The meta-analysis was performed by RevMan 5.3.Results A total of 14 studies with 1 160 patients were enrolled in the final study, and 12 studies were of high quality. RAMIE did not significantly prolong total operative time (P=0.20). No statistical difference was observed in the thoracic surgical time through the McKeown surgical approach (MD=3.35, 95%CI –3.93 to 10.62, P=0.37) or in surgical blood loss between RAMIE and VAMIE (MD=–9.48, 95%CI –27.91 to 8.95, P=0.31). While the RAMIE could dissect more lymph nodes in total and more lymph nodes along the left recurrent laryngeal recurrent nerve (MD=2.24, 95%CI 1.09 to 3.39, P=0.000 1; MD=0.89, 95%CI 0.13 to 1.65, P=0.02) and had a lower incidence of vocal cord paralysis (RR=0.70, 95%CI 0.53 to 0.92, P=0.009).Conclusion There is no statistical difference observed between RAMIE and VAMIE in surgical time and blood loss. RAMIE can harvest more lymph nodes than VAMIE, especially left laryngeal nerve lymph nodes. RAMIE shows a better performance in reducing the left laryngeal nerve injury and a lower rate of vocal cord paralysis compared with VAMIE.

Citation： LI Gang, ZHANG Jiani, SHEN Xu, ALAI Guha, XU Zhijie, SONG Tieniu, ZHU Yunke, LIN Yidan. Efficacy of Da Vinci robot-assisted minimally invasive esophagectomy versus video-assisted minimally invasive esophagectomy: A systematic review and meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(9): 1181-1188. doi: 10.7507/1007-4848.202009098 Copy

1.	Wee JO, Bravo-Iñiguez CE, Jaklitsch MT. Early experience of robot-assisted esophagectomy with circular end-to-end stapled anastomosis. Ann Thorac Surg, 2016, 102(1): 253-259.
2.	蔡华荣, 羽平, 周洪, 等. 胸腹腔镜联合食管癌根治术与传统食管癌根治术同期临床对照研究. 第三军医大学学报, 2014, 36(20): 2142-2144.
3.	Grimminger PP, Tagkalos E, Hadzijusufovic E, et al. Change from Hybrid to fully minimally invasive and robotic esophagectomy is possible without compromises. Thorac Cardiovasc Surg, 2019, 67(7): 589-596.
4.	Gisbertz SS, Hagens ERC, Ruurda JP, et al. The evolution of surgical approach for esophageal cancer. Ann N Y Acad Sci, 2018, 1434(1): 149-155.
5.	侯晓雯, 时景璞, 陈欣. 在Meta分析中如何利用中位数、极差和样本量估算均数、标准差. 中国循证医学杂志, 2015, 15(4): 484-487.
6.	Yerokun BA, Sun Z, Yang CJ, et al. Minimally invasive versus open esophagectomy for esophageal cancer: A population-based analysis. Ann Thorac Surg, 2016, 102(2): 416-423.
7.	Weksler B, Sullivan JL. Survival after esophagectomy: A propensity-matched study of different surgical approaches. Ann Thorac Surg, 2017, 104(4): 1138-1146.
8.	Deng HY, Luo J, Li SX, et al. Does robot-assisted minimally invasive esophagectomy really have the advantage of lymphadenectomy over video-assisted minimally invasive esophagectomy in treating esophageal squamous cell carcinoma? A propensity score-matched analysis based on short-term outcomes. Dis Esophagus, 2019, 32(7): doy110.
9.	Deng HY, Huang WX, LI G, et al. Comparison of short-term outcomes between robot-assisted minimally invasive esophagectomy and video-assisted minimally invasive esophagectomy in treating middle thoracic esophageal cancer. Dis Esophagus, 2018, 31(8): doy012.
10.	Zhang Y, Han Y, Gan Q, et al. Early outcomes of robot-assisted versus thoracoscopic-assisted Ivor Lewis esophagectomy for esophageal cancer: A propensity score-matched study. Ann Surg Oncol, 2019, 26(5): 1284-1291.
11.	Tagkalos E, Goense L, Hoppe-Lotichius M, et al. Robot-assisted minimally invasive esophagectomy (RAMIE) compared to conventional minimally invasive esophagectomy (MIE) for esophageal cancer: A propensity-matched analysis. Dis Esophagus, 2020, 33(4): doz060.
12.	He H, Wu Q, Wang Z, et al. Short-term outcomes of robot-assisted minimally invasive esophagectomy for esophageal cancer: A propensity score matched analysis. J Cardiothorac Surg, 2018, 13(1): 52.
13.	Chao YK, Hsieh MJ, Liu YH, et al. Lymph node evaluation in robot-assisted versus video-assisted thoracoscopic esophagectomy for esophageal squamous cell carcinoma: A propensity-matched analysis. World J Surg, 2018, 42(2): 590-598.
14.	Motoyama S, Sato Y, Wakita A, et al. Extensive lymph node dissection around the left laryngeal nerve achieved with robot-assisted thoracoscopic esophagectomy. Anticancer Res, 2019, 39(3): 1337-1342.
15.	Osaka Y, Tachibana S, Ota Y, et al. Usefulness of robot-assisted thoracoscopic esophagectomy. Gen Thorac Cardiovasc Surg, 2018, 66(4): 225-231.
16.	张晓彬, 杨煜, 叶波, 等. 达芬奇机器人手术系统辅助与胸腹腔镜联合辅助食管癌根治术的疗效分析. 中华消化外科杂志, 2017, 16(8): 844-849.
17.	Park S, Hwang Y, Lee HJ, et al. Comparison of robot-assisted esophagectomy and thoracoscopic esophagectomy in esophageal squamous cell carcinoma. J Thorac Dis, 2016, 8(10): 2853-2861.
18.	Chen J, Liu Q, Zhang X, et al. Comparisons of short-term outcomes between robot-assisted and thoraco-laparoscopic esophagectomy with extended two-field lymph node dissection for resectable thoracic esophageal squamous cell carcinoma. J Thorac Dis, 2019, 11(9): 3874-3880.
19.	Suda K, Ishida Y, Kawamura Y, et al. Robot-assisted thoracoscopic lymphadenectomy along the left recurrent laryngeal nerve for esophageal squamous cell carcinoma in the prone position: Technical report and short-term outcomes. World J Surg, 2012, 36(7): 1608-1616.
20.	Weksler B, Sharma P, Moudgill N, et al. Robot-assisted minimally invasive esophagectomy is equivalent to thoracoscopic minimally invasive esophagectomy. Dis Esophagus, 2012, 25(5): 403-409.
21.	王昕田, 焦嘉, 杜铭, 机器人手术系统辅助食管癌根治术与胸腹腔镜联合食管癌根治术的近期疗效比较. 重庆医科大学学报, 2019, 44(6): 807-810.
22.	Bongiolatti S, Annecchiarico M, Di Marino M, et al. Robot-sewn Ivor-Lewis anastomosis: Preliminary experience and technical details. Int J Med Robot, 2016, 12(3): 421-426.
23.	van Hillegersberg R, Boone J, Draaisma WA, et al. First experience with robot-assisted thoracoscopic esophagolymphadenectomy for esophageal cancer. Surg Endosc, 2006, 20(9): 1435-1439.
24.	Egberts JH, Schlemminger M, Hauser C, et al. Robot-assisted McKeown procedure via a cervical mediastinoscopy avoiding an abdominal and thoracic incision. Thorac Cardiovasc Surg, 2019, 67(7): 610-614.
25.	Zhang YJ, Xiang J, Han Y, et al. Initial experience of robot-assisted Ivor-Lewis esophagectomy: 61 consecutive cases from a single Chinese institution. Dis Esophagus, 2018, 31(12): doy048.
26.	Suda K, Nakauchi M, Inaba K, et al. Robotic surgery for upper gastrointestinal cancer: Current status and future perspectives. Dig Endosc, 2016, 28(7): 701-713.
27.	Tachibana S, Ota Y, Suda T, et al. Lymph node evaluation in robot-assisted versus video-assisted thoracoscopic esophagectomy for esophageal squamous cell carcinoma: A propensity-matched analysis. Gen Thorac Cardiovasc Surg, 2018, 42(2): 590-598.
28.	Park SY, Kim DJ, Kang DR, et al. Learning curve for robotic esophagectomy and dissection of bilateral recurrent laryngeal nerve nodes for esophageal cancer. Dis Esophagus, 2017, 30(12): 1-9.
29.	Yang Y, Zhang XB, Li B, et al. Robot-assisted esophagectomy (RAE) versus conventional minimally invasive esophagectomy (MIE) for resectable esophageal squamous cell carcinoma: protocol for a multicenter prospective randomized controlled trial (RAMIE trial, robot-assisted minimally invasive Esophagectomy). BMC Cancer, 2019, 19(1): 608.

1. Wee JO, Bravo-Iñiguez CE, Jaklitsch MT. Early experience of robot-assisted esophagectomy with circular end-to-end stapled anastomosis. Ann Thorac Surg, 2016, 102(1): 253-259.
2. 蔡华荣, 羽平, 周洪, 等. 胸腹腔镜联合食管癌根治术与传统食管癌根治术同期临床对照研究. 第三军医大学学报, 2014, 36(20): 2142-2144.
3. Grimminger PP, Tagkalos E, Hadzijusufovic E, et al. Change from Hybrid to fully minimally invasive and robotic esophagectomy is possible without compromises. Thorac Cardiovasc Surg, 2019, 67(7): 589-596.
4. Gisbertz SS, Hagens ERC, Ruurda JP, et al. The evolution of surgical approach for esophageal cancer. Ann N Y Acad Sci, 2018, 1434(1): 149-155.
5. 侯晓雯, 时景璞, 陈欣. 在Meta分析中如何利用中位数、极差和样本量估算均数、标准差. 中国循证医学杂志, 2015, 15(4): 484-487.
6. Yerokun BA, Sun Z, Yang CJ, et al. Minimally invasive versus open esophagectomy for esophageal cancer: A population-based analysis. Ann Thorac Surg, 2016, 102(2): 416-423.
7. Weksler B, Sullivan JL. Survival after esophagectomy: A propensity-matched study of different surgical approaches. Ann Thorac Surg, 2017, 104(4): 1138-1146.
8. Deng HY, Luo J, Li SX, et al. Does robot-assisted minimally invasive esophagectomy really have the advantage of lymphadenectomy over video-assisted minimally invasive esophagectomy in treating esophageal squamous cell carcinoma? A propensity score-matched analysis based on short-term outcomes. Dis Esophagus, 2019, 32(7): doy110.
9. Deng HY, Huang WX, LI G, et al. Comparison of short-term outcomes between robot-assisted minimally invasive esophagectomy and video-assisted minimally invasive esophagectomy in treating middle thoracic esophageal cancer. Dis Esophagus, 2018, 31(8): doy012.
10. Zhang Y, Han Y, Gan Q, et al. Early outcomes of robot-assisted versus thoracoscopic-assisted Ivor Lewis esophagectomy for esophageal cancer: A propensity score-matched study. Ann Surg Oncol, 2019, 26(5): 1284-1291.
11. Tagkalos E, Goense L, Hoppe-Lotichius M, et al. Robot-assisted minimally invasive esophagectomy (RAMIE) compared to conventional minimally invasive esophagectomy (MIE) for esophageal cancer: A propensity-matched analysis. Dis Esophagus, 2020, 33(4): doz060.
12. He H, Wu Q, Wang Z, et al. Short-term outcomes of robot-assisted minimally invasive esophagectomy for esophageal cancer: A propensity score matched analysis. J Cardiothorac Surg, 2018, 13(1): 52.
13. Chao YK, Hsieh MJ, Liu YH, et al. Lymph node evaluation in robot-assisted versus video-assisted thoracoscopic esophagectomy for esophageal squamous cell carcinoma: A propensity-matched analysis. World J Surg, 2018, 42(2): 590-598.
14. Motoyama S, Sato Y, Wakita A, et al. Extensive lymph node dissection around the left laryngeal nerve achieved with robot-assisted thoracoscopic esophagectomy. Anticancer Res, 2019, 39(3): 1337-1342.
15. Osaka Y, Tachibana S, Ota Y, et al. Usefulness of robot-assisted thoracoscopic esophagectomy. Gen Thorac Cardiovasc Surg, 2018, 66(4): 225-231.
16. 张晓彬, 杨煜, 叶波, 等. 达芬奇机器人手术系统辅助与胸腹腔镜联合辅助食管癌根治术的疗效分析. 中华消化外科杂志, 2017, 16(8): 844-849.
17. Park S, Hwang Y, Lee HJ, et al. Comparison of robot-assisted esophagectomy and thoracoscopic esophagectomy in esophageal squamous cell carcinoma. J Thorac Dis, 2016, 8(10): 2853-2861.
18. Chen J, Liu Q, Zhang X, et al. Comparisons of short-term outcomes between robot-assisted and thoraco-laparoscopic esophagectomy with extended two-field lymph node dissection for resectable thoracic esophageal squamous cell carcinoma. J Thorac Dis, 2019, 11(9): 3874-3880.
19. Suda K, Ishida Y, Kawamura Y, et al. Robot-assisted thoracoscopic lymphadenectomy along the left recurrent laryngeal nerve for esophageal squamous cell carcinoma in the prone position: Technical report and short-term outcomes. World J Surg, 2012, 36(7): 1608-1616.
20. Weksler B, Sharma P, Moudgill N, et al. Robot-assisted minimally invasive esophagectomy is equivalent to thoracoscopic minimally invasive esophagectomy. Dis Esophagus, 2012, 25(5): 403-409.
21. 王昕田, 焦嘉, 杜铭, 机器人手术系统辅助食管癌根治术与胸腹腔镜联合食管癌根治术的近期疗效比较. 重庆医科大学学报, 2019, 44(6): 807-810.
22. Bongiolatti S, Annecchiarico M, Di Marino M, et al. Robot-sewn Ivor-Lewis anastomosis: Preliminary experience and technical details. Int J Med Robot, 2016, 12(3): 421-426.
23. van Hillegersberg R, Boone J, Draaisma WA, et al. First experience with robot-assisted thoracoscopic esophagolymphadenectomy for esophageal cancer. Surg Endosc, 2006, 20(9): 1435-1439.
24. Egberts JH, Schlemminger M, Hauser C, et al. Robot-assisted McKeown procedure via a cervical mediastinoscopy avoiding an abdominal and thoracic incision. Thorac Cardiovasc Surg, 2019, 67(7): 610-614.
25. Zhang YJ, Xiang J, Han Y, et al. Initial experience of robot-assisted Ivor-Lewis esophagectomy: 61 consecutive cases from a single Chinese institution. Dis Esophagus, 2018, 31(12): doy048.
26. Suda K, Nakauchi M, Inaba K, et al. Robotic surgery for upper gastrointestinal cancer: Current status and future perspectives. Dig Endosc, 2016, 28(7): 701-713.
27. Tachibana S, Ota Y, Suda T, et al. Lymph node evaluation in robot-assisted versus video-assisted thoracoscopic esophagectomy for esophageal squamous cell carcinoma: A propensity-matched analysis. Gen Thorac Cardiovasc Surg, 2018, 42(2): 590-598.
28. Park SY, Kim DJ, Kang DR, et al. Learning curve for robotic esophagectomy and dissection of bilateral recurrent laryngeal nerve nodes for esophageal cancer. Dis Esophagus, 2017, 30(12): 1-9.
29. Yang Y, Zhang XB, Li B, et al. Robot-assisted esophagectomy (RAE) versus conventional minimally invasive esophagectomy (MIE) for resectable esophageal squamous cell carcinoma: protocol for a multicenter prospective randomized controlled trial (RAMIE trial, robot-assisted minimally invasive Esophagectomy). BMC Cancer, 2019, 19(1): 608.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Efficacy of Da Vinci robot-assisted minimally invasive esophagectomy versus video-assisted minimally invasive esophagectomy: A systematic review and meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content