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Updated: Jul 31, 2025
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An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
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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
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.
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.
