AB117. SOH25_AB_065. Comparing outcomes following open, hybrid, minimally invasive, and robotic-assisted esophagectomy: a systematic review
Systematic Reviews Session

AB117. SOH25_AB_065. Comparing outcomes following open, hybrid, minimally invasive, and robotic-assisted esophagectomy: a systematic review

Niamh Dunne1, Noel Donlon1, Matthew Davey2

1Department of Upper Gastrointestinal Surgery, St. James Cancer Institute, St. James Hospital, Dublin, Ireland; 2Department of Surgery, Royal College of Surgeons, Royal College of Surgeons in Ireland, Dublin, Ireland

Background: Esophagectomy is the standard of care for patients requiring surgical resection of oesophageal pathologies.

Methods: A systematic search of the Embase, Scopus, and PubMed databases was performed to identify randomised controlled trials (RCTs) comparing open esophagectomy (OE), hybrid esophagectomy (HE), laprascopic minimally invasive esophagectomy (LMIE), and robotic-assisted minimally invasive esophagectomy (RAMIE). Descriptive statistics were performed using SPSS v26.0.

Results: Twenty-two RCTs with 2,842 patients were included. Overall, 52.2% of patients underwent OE (1,484/2,842), 4.2% underwent HE (119/2,842), 29.6% underwent LMIE (840/2,842) and 14.0% underwent RAMIE (399/2,842). LMIE and RAMIE demonstrated reduced pulmonary complications and hospital stay compared with OE. RAMIE achieved superior lymph node dissection rates, compared to LMIE. HE demonstrated lower complication rates than OE, with comparable lymph node yields. In-hospital mortality remained low across all groups, with no significant differences, though LMIE and RAMIE had demonstrated better short-term recovery. Long-term survival and disease-free survival rates were largely comparable across all techniques. Quality of life (QOL) metrics 1-year post-surgery indicated that LMIE and RAMIE provided better physical functioning, pain reduction, and social functioning than OE.

Conclusions: LMIE and RAMIE reduced blood loss, pulmonary complications, hospital stays, and improved lymph node harvests compared to OE, while improving QOL. However, no significant differences were found in rates of surgical site infection, chyle leak, mortality, survival or oncological outcomes among the techniques were observed. Thus, minimally invasive techniques should be promoted in suitable cases where possible, should surgeon and institution expertise allow.

Keywords: Esophagectomy; oesophageal cancer; minimally invasive; open; robotic

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab117
Cite this abstract as: Dunne N, Donlon N, Davey M. AB117. SOH25_AB_065. Comparing outcomes following open, hybrid, minimally invasive, and robotic-assisted esophagectomy: a systematic review. Mesentery Peritoneum 2025;9:AB117.

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