Evidence map›Paper›PMID 36203109›Full record

ArticleSurgical endoscopy2023

Implementation of the robotic abdominal phase during robot-assisted minimally invasive esophagectomy (RAMIE): results from a high-volume center.

E M de Groot, L Goense, B F Kingma, J W van den Berg, J P Ruurda, R van Hillegersberg

Abstract read
In one paragraph

Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

E M de GrootDepartment of Surgery, University Medical Center Utrecht, Heidelberglaan 100, POBOX 85500, 3508 GA, Utrecht, Netherlands.ORCID http://orcid.org/0000-0001-9951-8165
L GoenseDepartment of Surgery, University Medical Center Utrecht, Heidelberglaan 100, POBOX 85500, 3508 GA, Utrecht, Netherlands.
B F KingmaDepartment of Surgery, University Medical Center Utrecht, Heidelberglaan 100, POBOX 85500, 3508 GA, Utrecht, Netherlands.
J W van den BergDepartment of Surgery, University Medical Center Utrecht, Heidelberglaan 100, POBOX 85500, 3508 GA, Utrecht, Netherlands.
J P RuurdaDepartment of Surgery, University Medical Center Utrecht, Heidelberglaan 100, POBOX 85500, 3508 GA, Utrecht, Netherlands.
R van HillegersbergDepartment of Surgery, University Medical Center Utrecht, Heidelberglaan 100, POBOX 85500, 3508 GA, Utrecht, Netherlands. r.vanhillegersberg@umcutrecht.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEvidence on the added value of robotic-assistance in the abdominal phase during esophagectomy is scarce. In 2003, our center implemented the robotic thoracic phase for esophagectomy. In November 2018 the robot was also implemented in the abdominal phase. The aim of this study was to evaluate the implementation of the abdominal phase during robot-assisted minimally invasive esophagectomy (RAMIE).

methodsConsecutive patients who underwent full RAMIE with intrathoracic anastomosis for esophageal cancer were included. Patients were extracted from a prospectively maintained institutional database. A cumulative sum (CUSUM) analysis was performed for abdominal operation time and abdominal lymph node yield. Intraoperative, postoperative and oncological outcomes including collected lymph nodes per abdominal lymph node station were reported.

resultsBetween 2018 and 2021, 70 consecutive patients were included. The majority of the patients had an adenocarcinoma (n = 55, 77%) and underwent neoadjuvant chemo(radio)therapy (n = 65, 95%). The median operative time for the abdominal phase was 180 min (range 110-233). The CUSUM analysis for abdominal operation time showed a plateau at case 22. There were no intraoperative complications or conversions during the abdominal phase. The most common postoperative complications were pneumonia (n = 18, 26%) and anastomotic leakage (n = 14, 20%). Radical resection margins were achieved in 69 (99%) patients. The median total lymph node yield was 42 (range 23-83) and the median abdominal lymph node yield was 16 (range 2-43). The CUSUM analysis for abdominal lymph node yield showed a plateau at case 21. Most abdominal lymph nodes were collected from the left gastric artery (median 4, range 0-20).

conclusionsThis study shows that a robotic abdominal phase was safely implemented for RAMIE without compromising intraoperative, postoperative and oncological outcomes. The learning curve is estimated to be 22 cases in a high-volume center with experienced upper GI robotic surgeons.

Indexed as

BoehmeriaEsophageal NeoplasmsRoboticsRobotic Surgical ProceduresEsophagectomyHumansLymph Node ExcisionMinimally Invasive Surgical ProceduresPostoperative ComplicationsTreatment OutcomeAbdominal phaseEsophagectomyLearning curveRAMIERobot

Identifiers

PMID36203109
PMCPMC9945034

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.