초록접수 현황
| 17F-195 | 구연 발표 |
Surgical Outcomes of Robot Assisted Minimally Invasive Versus Open Esophagectomy for Patients with Esophageal Squamous Cell Carcinoma : An Inverse Probability of Treatment Weighted Analysis.
Byung Kwon Chong¹, Ho-jin Kim¹, Bum Soo Kim², Chan Wook Kim², In-Seob Lee², Chung-Sik Gong², Geun Dong Lee¹, Se Hoon Choi¹, Hyeong Ryul Kim¹, Dong Kwan Kim¹, Seung Il Park¹, Yong-Hee Kim¹
¹Department of Thoracic & Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea., ²Department of Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
Purpose : This study sought to find the benefits of robot assisted total minimally invasive esophagectomy (RAMIE) technique in comparison with conventional open esophageal operation.
Methods : From 2012 to 2016, 371 patients with esophageal squamous cell carcinoma performed Ivor Lewis or Mckeown operation by a single surgeon. A total of 130 patients had laparoscopic gastric conduit formation and followed by robot assisted minimally invasive esophagectomy while 241 patients had conventional esophageal surgery including laparotomy and open esophagectomy(OE). Using inverse probability of treatment weighting (IPTW) propensity score, baseline differences were adjusted and clinical outcomes were compared between two groups.
Results : All-cause mortality and morbidity rate was significantly higher in OE group (38.6%) than RAMIE group (23.8%) (P = 0.018). (Table 4) There were no significant difference in early, overall mortality rate and recurrence rate. Kaplan-Meier curve displays did not achieved statistical significance in overall (P = 0.051) and disease-free survival (P = 0.217). Cox proportional-hazard analysis demonstrated wound problem [HR = 0.16; CI (0.02-0.57); P = 0.017], pneumonia [HR = 0.23; CI (0.06-0.68); P = 0.019], and use of vasopressors [HR = 0.14; CI (0.08-0.25); P = 0.001] were independent predictors of early mortality.
Conclusion : Our analysis shows that post-operative morbidity and mortality of RAMIE were comparable to that of conventional procedure. Moreover all-cause mortality and morbidity rate was significantly lower in RAMIE. Better outcomes of RAMIE might have been resulted from lower incidence of pneumonia and wound problem with lesser use of vasopressors which themselves were independent predictors of poor survival.
Methods : From 2012 to 2016, 371 patients with esophageal squamous cell carcinoma performed Ivor Lewis or Mckeown operation by a single surgeon. A total of 130 patients had laparoscopic gastric conduit formation and followed by robot assisted minimally invasive esophagectomy while 241 patients had conventional esophageal surgery including laparotomy and open esophagectomy(OE). Using inverse probability of treatment weighting (IPTW) propensity score, baseline differences were adjusted and clinical outcomes were compared between two groups.
Results : All-cause mortality and morbidity rate was significantly higher in OE group (38.6%) than RAMIE group (23.8%) (P = 0.018). (Table 4) There were no significant difference in early, overall mortality rate and recurrence rate. Kaplan-Meier curve displays did not achieved statistical significance in overall (P = 0.051) and disease-free survival (P = 0.217). Cox proportional-hazard analysis demonstrated wound problem [HR = 0.16; CI (0.02-0.57); P = 0.017], pneumonia [HR = 0.23; CI (0.06-0.68); P = 0.019], and use of vasopressors [HR = 0.14; CI (0.08-0.25); P = 0.001] were independent predictors of early mortality.
Conclusion : Our analysis shows that post-operative morbidity and mortality of RAMIE were comparable to that of conventional procedure. Moreover all-cause mortality and morbidity rate was significantly lower in RAMIE. Better outcomes of RAMIE might have been resulted from lower incidence of pneumonia and wound problem with lesser use of vasopressors which themselves were independent predictors of poor survival.
첨부파일 : 추계_Figures_Tables.docx
책임저자: Yong-Hee Kim
Department of Thoracic & Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
발표자: Yong-Hee Kim, E-mail : kimyh67md@hotmail.com