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Bongiolatti et al. Mini-invasive Surg 2020;4:41 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.28

Systematic Review Open Access

Robot-assisted minimally invasive esophagectomy:
systematic review on surgical and oncological

outcomes

Stefano Bongiolatti , Arianna Farronato , Michele Di Marino , Mario Annecchiarico , Francesco Coratti ,
3
2
1
1
2
Fabio Cianchi , Andrea Coratti , Luca Voltolini 1
3
2
1 Thoracic Surgery Unit, Careggi University Hospital, Florence 50134, Italy.
2 Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence 50134, Italy.
3 Division of Digestive Surgery, Careggi University Hospital, Florence 50134, Italy.
Correspondence to: Dr. Stefano Bongiolatti, Thoracic Surgery Unit, University Hospital Careggi, Largo Brambilla, 1, Florence
50134, Italy. E-mail: stefanobongiolatti@gmail.com
How to cite this article: Bongiolatti S, Farronato A, Di Marino M, Annecchiarico M, Coratti F, Cianchi F, Coratti A, Voltolini L.
Robot-assisted minimally invasive esophagectomy: systematic review on surgical and oncological outcomes. Mini-invasive Surg
2020;4:41. http://dx.doi.org/10.20517/2574-1225.2020.28

Received: 28 Feb 2020 First Decision: 1 Apr 2020 Revised: 15 Apr 2020 Accepted: 25 May 2020 Published: 12 Jul 2020
Academic Editor: Itasu Ninomiya Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Aim: Esophagectomy is associated with several post-operative complications (50%-70%) due to surgical
trauma. Minimally invasive techniques have therefore been applied to decrease mortality and morbidity. Robot-
assisted minimally-invasive esophagectomy (RAMIE) was developed to overcome the drawbacks of the thoraco-
laparoscopic approach. The objective of this systematic review is to report some recent experiences and to
compare RAMIE with other approaches to esophagectomy, focusing on technical and oncological aspects.

Methods: Pubmed, Embase and Scopus databases were searched for “robot-assisted esophagectomy”, “minimally
invasive esophagectomy” and “robotic esophagectomy” in January 2020. The study was focused on original
papers on totally endoscopic RAMIE in the English language. No statistical procedures (meta-analysis) were
performed.

Results: Three hundred and twenty studies were identified across the database and after screening and
reviewing, 14 were included for final analysis. The overall 90-day post-operative mortality after trans-thoracic
esophagectomy ranged from 0% to 9% and did not differ between approaches. Post-operative complications
ranged between 24% and 60.9%: respiratory (6.25% to 65%), cardiac (0.8% to 32%), anastomotic leak (3.1% and

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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