OA05.5. Short- and Long-Term Outcomes of RAMIE Versus MIE: Importance of Surgical Maturity and Institutional Education

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ID: 325655
2026
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Ranked #52 of 453 articles by views in diseases of the esophagus : official journal of the international society for diseases of the esophagus

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Abstract
Abstract Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer – long term outcomes Background Robot-assisted minimally invasive esophagectomy (RAMIE) has been increasingly performed since 2018, but its clear advantages over minimally invasive esophagectomy (MIE) remain unclear. We examined our institution’s short-term outcomes and their evolution since RAMIE adoption and analyzed long-term survival to assess RAMIE’s benefits. Methods We compared short- and long-term outcomes of 222 RAMIE and 488 MIE cases (2014–2025). RAMIE outcomes were further analyzed by surgical era and surgeon case volume. Long-term outcomes were assessed in cases up to 2024 using propensity score matching (PSM) with following covariates: age, gender, pre-operative treatments, location, cT, pT, cN, pN. Results Short-term results showed no significant differences in blood loss (median 11 vs. 18 mL), operative time (286 vs. 261 min), WBC and CRP, recurrent laryngeal nerve palsy (RLNP; 32% vs. 32%), or pneumonia (18% vs. 18%). RLNP rates improved markedly in recent years (41% to 22% since 2023) but were not affected by individual surgeon case volume. PSM analysis (168 matched pairs) showed better OS with RAMIE but no difference in RFS. Conclusion MIE is considered a mature technique; therefore, outcomes from a similarly mature phase of RAMIE should be used for fair comparison, as suggested by our recent RLNP result. Institutional rather than individual experience appears crucial for improving RLNP rates, highlighting the importance of education to young surgeon systematically within each institution. Although RAMIE could not show clear advantage in both short and long-term outcomes, further maturation of the RAMIE skill may enhance long-term survival.
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Authors Yusuke Taniyama, Hiroshi Okamoto, Chiaki Sato, Yohei Ozawa, Hirotaka Ishida, Naoto Ujiie, Takashi Kamei
Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.039
URL
https://doi.org/10.1093/dote/doag077.039
Keywords Keywords not found

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