Full RAMIE vs Hybrid RAMIE: a retrospective study on outcomes evaluation and cost considerations.

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Minimally invasive esophagectomy (MIE) is a standard treatment for esophageal cancer.
• Comparing fully robot-assisted MIE (F-RAMIE) with hybrid MIE (H-RAMIE) is crucial for optimizing patient outcomes and resource utilization.

Purpose of the Study:

• To compare the postoperative complications, clinical outcomes, oncological results, and costs of F-RAMIE versus H-RAMIE.
• To evaluate the safety and efficacy of these two MIE techniques.

Main Methods:

• Multicentric retrospective analysis of 100 patients undergoing F-RAMIE or H-RAMIE between 2018 and 2023.
• Comparison of primary endpoint (postoperative complications) and secondary endpoints (clinical outcomes, oncological results, costs).
• Survival analysis using the Kaplan-Meier method and detailed economic evaluation.

Main Results:

• F-RAMIE had longer operative time but significantly shorter Intensive Care Unit (ICU) stay compared to H-RAMIE.
• No significant differences were observed in conversion rates, overall postoperative complications, or length of hospital stay.
• F-RAMIE demonstrated superior lymph node retrieval, while R0 resection rates, overall survival, and recurrence rates were comparable between the groups.
• Cost analysis revealed a slight economic advantage for F-RAMIE, primarily due to reduced hospital stay costs.

Conclusions:

• Both F-RAMIE and H-RAMIE are equally safe and effective for esophagectomy regarding complications and oncological outcomes.
• F-RAMIE offers advantages in lymph node yield and ICU recovery, with potential cost savings.
• The choice between F-RAMIE and H-RAMIE may depend on specific institutional resources and patient factors.