ArticleAnnals of surgical oncology2025
The Current State of Robot-Assisted Minimally Invasive Esophagectomy (RAMIE): Outcomes from the Upper GI International Robotic Association (UGIRA) Esophageal Registry.
Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Stapled vs. hand-sewn anastomosis during esophagectomy: a randomized trials systematic review and meta-analysis.Updates in surgery · 2026Pooled it
- [Modern concepts in the surgical treatment of esophageal cancer].Chirurgie (Heidelberg, Germany) · 2026Review
- Textbook Outcome Failure After Esophagectomy in Patients Aged 70 Years or Older Across the Robotic Transition: Procedural and Intraoperative Determinants and Their Prognostic Consequences.Annals of surgical oncology · 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
- [Esophageal NEN: update on diagnostics and surgical treatment].Chirurgie (Heidelberg, Germany) · 2026Review
- A reproducible anastomosis in robotic Ivor-Lewis esophagectomy: a simple fix for a persistent problem in a zero-leak consecutive series.Surgical endoscopy · 2026Article
- Review
- Mapping the global landscape of robot-assisted minimally invasive esophagectomy (RAMIE): a bibliometric and visualized study.Journal of robotic surgery · 2026Article
- Too fast or too slow?: Considerations in the era of enhanced recovery and FAST Track for upper GI surgery.Surgical endoscopy · 2026Article
- One-Lung Ventilation Duration Is a Risk Factor for Pneumonia in Minimally Invasive and Robotic Esophagectomy.Journal of clinical medicine · 2026Article
- Article
- Short- and Long-term Outcomes of Robotic versus Conventional Minimally Invasive Esophagectomy for Esophageal Cancer: A Multicenter Propensity Score-matched Cohort Study.Annals of surgical oncology · 2026Article
- Textbook outcome can be reached in the learning curve for hybrid robot-assisted esophagectomy-experience from a German high-volume center.Journal of robotic surgery · 2026Article
- Short-term outcomes of robot-assisted versus conventional thoracoscopic esophagectomy: a nationwide inpatient database study in Japan.Esophagus : official journal of the Japan Esophageal Society · 2026Article
- Comparison of Short-Term Outcomes Between Robot-Assisted and Conventional Mediastinoscopic Esophagectomies: A Retrospective Study Using Propensity Score Matching.Annals of surgical oncology · 2026Article
- Optimizing perioperative care in esophagectomy: a narrative review.Journal of thoracic disease · 2026Review
- Single-sterilization modified-position robotic-assisted McKeown esophagectomy versus minimally invasive approach after neoadjuvant chemoimmunotherapy for locally advanced esophageal squamous cell carcinoma.Journal of thoracic disease · 2026Article
- The White Plane in Esophageal Surgery: A Novel Anatomical Landmark with Prognostic Significance.Cancers · 2025Article
- Selective Oral Decontamination of the Esophagus to Reduce Microbial Burden in Patients Undergoing Esophagectomy for Esophageal Cancer (SODA)-First Results from a Proof-of-Principle Study.Antibiotics (Basel, Switzerland) · 2025Article
- Global strategies for the diffusion of robotic surgery.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2025Review
Corrections and comments
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Authors and funding
45 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRobot-assisted minimally invasive esophagectomy (RAMIE) is increasingly adopted in centers worldwide, with ongoing refinements to enhance results. This study aims to assess the current state of RAMIE worldwide and to identify potential areas for improvement.
methodsThis descriptive study analyzed prospective data from esophageal cancer patients who underwent transthoracic RAMIE in Upper GI International Robotic Association (UGIRA) centers. Main endpoints included textbook outcome rate, surgical techniques, and perioperative outcomes. Analyses were performed separately for intrathoracic (Ivor-Lewis) and cervical anastomosis (McKeown), divided into three time cohorts (2016-2018, 2019-2020, 2021-2023). A sensitivity analysis was conducted with cases after the learning curve (> 70 cases).
resultsAcross 28 UGIRA centers, 2012 Ivor-Lewis and 1180 McKeown procedures were performed. Over the time cohorts, textbook outcome rates were 39%, 48%, and 49% for Ivor-Lewis, and 49%, 63%, and 61% for McKeown procedures, respectively. Fully robotic procedures accounted for 66%, 51%, and 60% of Ivor-Lewis procedures, and 53%, 81%, and 66% of McKeown procedures. Lymph node yield showed 27, 30, and 30 nodes in Ivor-Lewis procedures, and 26, 26, and 34 nodes in McKeown procedures. Furthermore, high mediastinal lymphadenectomy was performed in 65%, 43%, and 37%, and 70%, 48%, and 64% of Ivor-Lewis and McKeown procedures, respectively. Anastomotic leakage rates were 22%, 22%, and 16% in Ivor-Lewis cases, and 14%, 12%, and 11% in McKeown cases. Hospital stay was 13, 14, and 13 days for Ivor-Lewis procedures, and 12, 9, and 11 days for McKeown procedures. In Ivor-Lewis and McKeown, respectively, the sensitivity analysis revealed textbook outcome rates of 43%, 54%, and 51%, and 47%, 64%, and 64%; anastomotic leakage rates of 28%, 18%, and 15%, and 13%, 11%, and 10%; and hospital stay of 11, 12, and 12 days, and 10, 9, and 9 days.
conclusionsThis study demonstrates favorable outcomes over time in achieving textbook outcome after RAMIE. Areas for improvement include a reduction of anastomotic leakage and shortening of hospital stay.
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