Robotic Esophagectomy Compared With Open Esophagectomy Reduces Sarcopenia within the First Postoperative Year: A Propensity Score- Matched Analysis

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung



INTRODUCTION: Sarcopenia is a known risk factor for adverse outcomes after esophageal cancer (EC) surgery. Robot-assisted minimally invasive esophagectomy (RAMIE) offers numerous advantages, including reduced morbidity and mortality. However, no evidence exists to date comparing the development of sarcopenia after RAMIE and open esophagectomy (OE). The objective was to evaluate whether the development of sarcopenia within the first postoperative year after esophagectomy is associated with the surgical approach: RAMIE versus OE.

METHODS: A total of 168 patients with EC were analyzed who either underwent total robotic or fully open Ivor Lewis esophagectomy in a propensity score-matched analysis. Sarcopenia was assessed using the skeletal muscle index (cm2/m2) and psoas muscle thickness per height (mm/m) on axial computed tomography scans during the first postoperative year; in total 540 computed tomography scans were evaluated.

RESULTS: After 1-to-1 propensity score matching for confounders, 67 patients were allocated to RAMIE and OE groups, respectively. Skeletal muscle index in the OE group was significantly lower compared with the RAMIE group at the third (43.2 ± 7.6 cm2/m2 versus 49.1 ± 6.9 cm2/m2, p = 0.001), sixth (42.7 ± 7.8 cm2/m2 versus 51.5 ± 8.2 cm2/m2, p < 0.001) and ninth (43.0 ± 7.0 cm2/m2 versus 49.9 ± 6.6 cm2/m2, p = 0.015) postoperative month. Similar results were recorded for psoas muscle thickness per height.

CONCLUSIONS: To our knowledge, this study is the first to suggest a substantial benefit of RAMIE compared with open esophagectomy in terms of postoperative sarcopenia. These results add further evidence to support the implementation of the robotic approach in multimodal therapy of EC.


Seiten (von - bis)232-244
FachzeitschriftJournal of thoracic oncology
Frühes Online-DatumJan. 2023
PublikationsstatusVeröffentlicht - Feb. 2023

Externe IDs

PubMed 36343921
Scopus 85143162370
Mendeley 606a5dd2-3aea-397d-8f72-9752502642f3
ORCID /0000-0001-5061-9643/work/147674435


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  • Esophageal cancer, Esophagectomy, Pmth, Ramie, Smi, Sarcopenia, Sarcopenia/etiology, Esophagectomy/adverse effects, Humans, Postoperative Complications/etiology, Treatment Outcome, Robotics, Propensity Score, Esophageal Neoplasms, Lung Neoplasms/surgery, Minimally Invasive Surgical Procedures/adverse effects, Robotic Surgical Procedures/adverse effects, SMI, PMTH, RAMIE