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Robot-assisted versus thoracolaparoscopic oesophagectomy for locally advanced oesophageal squamous cell carcinoma after neoadjuvant chemoradiotherapy

  • Author Footnotes
    1 Haoyao Jiang and Xufeng Guo contributed equally to this work.
    Haoyao Jiang
    Footnotes
    1 Haoyao Jiang and Xufeng Guo contributed equally to this work.
    Affiliations
    Department of Thoracic Surgery, Section of Oesophageal Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, 200030, China
    Search for articles by this author
  • Author Footnotes
    1 Haoyao Jiang and Xufeng Guo contributed equally to this work.
    Xufeng Guo
    Footnotes
    1 Haoyao Jiang and Xufeng Guo contributed equally to this work.
    Affiliations
    Department of Thoracic Surgery, Section of Oesophageal Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, 200030, China
    Search for articles by this author
  • Yifeng Sun
    Affiliations
    Department of Thoracic Surgery, Section of Oesophageal Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, 200030, China
    Search for articles by this author
  • Rong Hua
    Affiliations
    Department of Thoracic Surgery, Section of Oesophageal Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, 200030, China
    Search for articles by this author
  • Bin Li
    Affiliations
    Department of Thoracic Surgery, Section of Oesophageal Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, 200030, China
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  • Zhigang Li
    Correspondence
    Corresponding author. Department of Thoracic Surgery, Section of Oesophageal Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, No. 241 West Huaihai Road, Shanghai, 200030, China.
    Affiliations
    Department of Thoracic Surgery, Section of Oesophageal Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, 200030, China
    Search for articles by this author
  • Author Footnotes
    1 Haoyao Jiang and Xufeng Guo contributed equally to this work.
Published:November 28, 2022DOI:https://doi.org/10.1016/j.ejso.2022.11.102

      Abstract

      Introduction

      Robot-assisted oesophagectomy (RAE) and thoracolaparoscopic oesophagectomy (TLE) are surgical techniques for the treatment of oesophageal cancer. This study aimed to compare the perioperative and mid-term outcomes of RAE versus TLE for patients with locally advanced oesophageal squamous cell carcinoma (ESCC) undergoing neoadjuvant chemoradiotherapy (nCRT).

      Methods

      Consecutive patients receiving nCRT plus RAE or TLE were retrospectively included in this single-institution study from January 2016 to January 2021. Perioperative outcomes were compared and survival analysis was performed.

      Results

      This study enrolled 251 patients, 80 (31.9%) in RAE and 171 (68.1%) in TLE. The conversion rate was equivalent in RAE versus TLE (3.8% vs 2.9%, P = 1). Median operative time in RAE was significantly shorter than that in TLE (254 vs 289 min, P < 0.001). Compared to TLE, RAE harvested more lymph nodes along the recurrent laryngeal nerve [4 (3–6) vs 3 (1–5), P < 0.001]. Overall complications were similar in RAE compared to TLE (38.8% vs 38.0%, P = 0.911). No statistically significant difference in disease-free survival (log-rank P = 0.721) or overall survival (log-rank P = 0.325) was found between groups.

      Conclusions

      Compared to TLE, RAE could achieve shorter operative duration and better lymph nodes dissection along the bilateral RLN for locally advanced ESCC after nCRT, with comparable short-term outcomes. A long-term survival remains to be verified.

      Keywords

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