ArticleSurgical endoscopy2021
Outcomes of robotic esophagectomies for esophageal cancer by hospital volume: an analysis of the national cancer database.
Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- The Impact of Hospital Volume on Postoperative Outcomes for Esophagectomy and Gastrectomy: A Systematic Review and Meta-analysis.Annals of surgical oncology · 2026Pooled it
- Volume-outcome relationship in intra-abdominal robotic-assisted surgery: a systematic review.Journal of robotic surgery · 2023Pooled it
- Is robotic surgery meeting nodal benchmarks? AJCC and NCCN-based evaluation of lymph node yield and survival in robotic transhiatal esophagectomy.Surgical endoscopy · 2026Article
- Robotic Ivor Lewis esophagectomy experience and outcomes from a high-volume cancer center with propensity-matched comparative assessment to the ACS-NSQIP database.Surgical endoscopy · 2026Article
- The Financial Argument for Centralization of Care for Esophagectomy.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Tele-robot-assisted minimally invasive esophagectomy using a double-surgeon cockpit on a cadaver.Surgery today · 2025Article
- Robot-assisted functional minimally invasive radical resection of esophageal cancer.World journal of surgical oncology · 2025Article
- Caseload per Year in Robotic-Assisted Minimally Invasive Esophagectomy: A Narrative Review.Cancers · 2024Review
- Long-term survival outcomes associated with robotic-assisted minimally invasive esophagectomy (RAMIE) for esophageal cancer.Surgical endoscopy · 2023Article
- Facility Volume Thresholds for Optimization of Short- and Long-Term Outcomes in Patients Undergoing Hepatectomy for Primary Liver Tumors.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Intraoperative fluorescence imaging in esophagectomy and its application to the robotic platform: a narrative review.Journal of thoracic disease · 2022Review
- Robot-assisted Ivor Lewis Esophagectomy (RAILE): A review of surgical techniques and clinical outcomes.Frontiers in surgery · 2022Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRobotic minimally invasive esophagectomies (RMIE) have been associated with superior outcomes; however, it is unclear if these are specific to robotic technique or are present only at high-volume institutions. We hypothesize that low-volume RMIE centers would have inferior outcomes.
methodsThe National Cancer Database (NCDB) identified patients receiving RMIE from 2010 to 2016. Based on the total number of RMIE performed by each hospital system, the lowest quartile performed ≤ 9 RMIE over the study period. Ninety-day mortality, number of lymph nodes evaluated, margins status, unplanned readmissions, length of stay (LOS), and overall survival were compared. Regression models were used to account for confounding.
results1565 robotic esophagectomies were performed by 212 institutions. 173 hospitals performed ≤ 9 RMIE (totaling 478 operations over the study period, 30.5% of RMIE) and 39 hospitals performed > 9 RMIE (1087 operations, 69.5%). Hospitals performing > 9 RMIE were more likely to be academic centers (90.4% vs 66.2%, p < 0.001), have patients with advanced tumor stage (65.3% vs 59.8%, p = 0.049), andadministered preoperative radiation (72.8% vs 66.3%, p = 0.010). There were no differences based on demographics, nodal stage, or usage of preoperative chemotherapy. On multivariable regressions, hospitals performing ≤ 9 RMIE were associated with a greater likelihood of experiencing a 90-day mortality, a reduced number of lymph nodes evaluated, and a longer LOS; however, there was no association with rates of positive margins or unplanned readmissions. Median overall survival was decreased at institutions performing ≤ 9 RMIE (37.3 vs 51.5 months, p < 0.001). Multivariable Cox regression demonstrated an association with poor survival comparing hospitals performing ≤ 9 to > 9 RMIE (HR 1.327, p = 0.018).
conclusionMany robotic esophagectomies occur at institutions which performed relatively few RMIE and were associated with inferior short- and long-term outcomes. These data argue for regionalization of robotic esophagectomies or enhanced training in lower volume hospitals.
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