ArticleJournal of robotic surgery2025
Robotic versus open esophagectomy: a propensity score-matched analysis from a tertiary cancer center in India.
Article in Journal of robotic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
Robotic esophagectomy has gained prominence over open esophagectomy for resectable esophageal cancer. However, high-quality comparative data remain limited, particularly from the Indian subcontinent. This study compares perioperative and long-term outcomes between robotic and open esophagectomy using propensity score matching. We analyzed 209 patients who underwent McKeown's total esophagectomy between January 2014 and December 2024 at a tertiary cancer center in India. Patients were divided into robotic (n = 156) and open esophagectomy (n = 53) groups. In robotic, the thoracic component was performed robotically, while cervical and abdominal phases used conventional open techniques. All anastomoses were handsewn in a tensionless, two-layer manner. Propensity score matching created 48 matched pairs. Primary outcomes were overall survival (OS) and disease-free survival (DFS). After propensity matching, the robotic cohort demonstrated superior 5-year overall survival (64.7% vs 53.4%, p = 0.045). Robotic showed significant advantages in reduced blood loss (174 vs 237.7 ml, p < 0.003), hospital stay (11.7 vs 14.4 days, p = 0.013), extubation day (0.4 vs 0.8 days, p = 0.008), and ICU duration (2.2 vs 3.4 days, p = 0.001). Respiratory complications requiring ICU were lower in the robotic cohort (8.3% vs 22.9%, p = 0.049). Robotic esophagectomy offers survival advantages over open esophagectomy with superior perioperative outcomes. This appears driven by reduced perioperative morbidity rather than enhanced cancer control, supporting robot adoption in experienced centers.
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