Evidence map›Paper›PMID 41910808›Full record

ArticleJournal of robotic surgery2026

Learning curve analysis across three surgical eras in Ivor Lewis esophagectomy.

Mazen A Juratli, Franziska Viola Damhorst, Ann-Kathrin Eichelmann, Jennifer Merten, Nader El-Sourani, Mazen Aldarwish, Andreas Pascher, Jens Peter Hoelzen

Abstract read
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In one paragraph

Article in Journal of robotic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

8 authors.

Mazen A Juratli *Department of General, Visceral and Transplant Surgery, University Hospital Muenster, University of Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.
Franziska Viola Damhorst *Department of General, Visceral and Transplant Surgery, University Hospital Muenster, University of Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.
Ann-Kathrin EichelmannDepartment of General, Visceral and Transplant Surgery, University Hospital Muenster, University of Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.
Jennifer MertenDepartment of General, Visceral and Transplant Surgery, University Hospital Muenster, University of Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.
Nader El-SouraniDepartment of General, Visceral and Transplant Surgery, University Hospital Muenster, University of Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.
Mazen AldarwishDepartment of General, Visceral and Transplant Surgery, University Hospital Muenster, University of Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.
Andreas PascherDepartment of General, Visceral and Transplant Surgery, University Hospital Muenster, University of Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.
Jens Peter HoelzenDepartment of General, Visceral and Transplant Surgery, University Hospital Muenster, University of Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany. jenspeter.hoelzen@ukmuenster.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Comprehensive learning curve analyses across the evolution from open to robot-assisted esophagectomy remain limited. This retrospective single-center study analyzed 376 consecutive Ivor Lewis esophagectomies (2012–2023) across three eras: open (n = 127), hybrid-open (n = 52), and robot-assisted minimally invasive esophagectomy (RAMIE, n = 197). Learning curves were assessed using CUSUM analysis, and patient-specific factors were evaluated to guide case selection. Open esophagectomy reached plateau at case 65 with subsequent outcome deterioration. Hybrid-open achieved early plateau (case 15) but showed fluctuating metrics. RAMIE demonstrated steady improvement with CUSUM-derived stabilization achieved at cases 45–50 (hybrid-RAMIE) and 70 (total RAMIE), showing significant reductions in operative times, hospital stay, and ICU stay (p < 0.001). Higher BMI, advanced nodal disease, and comorbidity burden negatively impacted outcomes. In our center, CUSUM-derived stabilization was observed after approximately 45–50 cases for hybrid-RAMIE and about 70 cases for total RAMIE. Strategic case selection—prioritizing lower BMI, limited nodal burden, and minimal comorbidities may accelerate early stabilization of performance. High-volume centers may benefit from total-robotic approaches, while lower-volume programs may favor hybrid pathways.

Indexed as

Esophageal NeoplasmsEsophagectomyLearning CurveRobotic Surgical ProceduresFemaleHumansLength of StayMiddle AgedOperative TimeRetrospective StudiesCUSUM analysisEsophageal cancer surgeryLearning curveRobot-assisted minimally invasive esophagectomySurgical evolution

Identifiers

PMID41910808
PMCPMC13035626

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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.