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Related Experiment Video

Updated: Jul 31, 2025

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
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Drainless robot-assisted minimally invasive oesophagectomy-randomized controlled trial (RESPECT).

B Müssle1,2,3, J Kirchberg1,3,4,5,6, N Buck1,3,4,5,7

  • 1Department of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav CarusTechnische Universität Dresden, Dresden, Germany.

Trials
|May 1, 2023
PubMed
Summary

Early removal of drains after robot-assisted minimally invasive oesophagectomy (RAMIE) may reduce postoperative pain. This trial investigates the feasibility and effectiveness of a "drainless" approach in RAMIE patients, aiming to improve recovery and reduce complications.

Keywords:
ERAS (enhanced recovery after surgery)Oesophageal cancerOesophagectomyPostoperative painRAMIE

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Area of Science:

  • Surgical Oncology
  • Minimally Invasive Surgery
  • Enhanced Recovery Protocols

Background:

  • Robot-assisted minimally invasive oesophagectomy (RAMIE) is increasingly used for esophageal cancer.
  • Postoperative drains are standard but may contribute to pain and delayed recovery.
  • Evidence on early drain removal strategies in RAMIE is limited.

Purpose of the Study:

  • To evaluate the feasibility and effectiveness of early postoperative drain removal after RAMIE.
  • To assess the impact of early drain removal on postoperative pain, recovery, and morbidity.
  • To compare early drain removal versus conventional management in RAMIE.

Main Methods:

  • A randomized controlled multicentric trial involving 72 patients undergoing RAMIE.
  • Intervention group: abdominal and chest drains removed 3 hours post-surgery.
  • Control group: conventional drain management with standard algorithm for removal.

Main Results:

  • Primary endpoint: postoperative pain on the second postoperative day (NRS scale).
  • Secondary endpoints: pain intensity, analgesic use, imaging frequency, interventions, mobilization, morbidity, and mortality.
  • The trial aims to provide statistical evidence on the effectiveness and feasibility of the "drainless" RAMIE approach.

Conclusions:

  • No prior trials have investigated drain strategies in RAMIE for esophageal cancer regarding perioperative complications.
  • Minimally invasive surgery and ERAS protocols reduce morbidity but typically include drains.
  • This trial will provide evidence for the "drainless" RAMIE strategy, potentially improving patient outcomes.