Robotic Esophagectomy Compared With Open Esophagectomy Reduces Sarcopenia within the First Postoperative Year: A Propensity Score- Matched Analysis
Research output: Contribution to journal › Research article › Contributed › peer-review
Contributors
Abstract
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.
Details
Original language | English |
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Pages (from-to) | 232-244 |
Number of pages | 13 |
Journal | Journal of thoracic oncology |
Volume | 18 |
Issue number | 2 |
Early online date | Jan 2023 |
Publication status | Published - Feb 2023 |
Peer-reviewed | Yes |
External IDs
PubMed | 36343921 |
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Scopus | 85143162370 |
Mendeley | 606a5dd2-3aea-397d-8f72-9752502642f3 |
ORCID | /0000-0001-5061-9643/work/147674435 |
Keywords
Research priority areas of TU Dresden
DFG Classification of Subject Areas according to Review Boards
Subject groups, research areas, subject areas according to Destatis
Sustainable Development Goals
ASJC Scopus subject areas
Keywords
- 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