063. ROBOTIC ASSISTED MIMINALLY INVASIVE IVOR-LEWIS ESOPHAGECTOMY VERSUS CONVENTIONAL MINIMALLY INVASIVE IVOR-LEWIS ESOPHAGECTOMY

Abstract Background Minimally invasive technique for esophagectomy has emerged as the standard of care for resectable esophageal cancer. It is however a technically demanding procedure especially the creation of the intrathoracic anastomosis in Ivor-Lewis esophagectomy. The emergence of robotic assisted surgery is promising in the field of minimally invasive esophagectomy and is postulated to aid in surgery. This study examines the introduction of robotic assisted minimally invasive Ivor-Lewis esophagectomy in a tertiary center and compares short term complications and mortality to conventional minimally invasive Ivor-Lewis esophagectomy. Methods Hospital records of all robotic assisted minimally invasive Ivor-Lewis esophagectomy since the introduction in 2021 and conventional minimally invasive Ivor-Lewis esophagectomy since 2015 are obtained. Patients with intended at least chest phase minimally invasive are included. Baseline data are retrieved. Primary otucome measure is postoperative anastomotic leak grade 2 as defined by the ECCG. Secondary outcome measures are mortality and conversion rates. Results A total of 250 patients are operated, 170 minimally invasive Ivor-Lewis esophagectomy and 80 robotic assisted minimally invasive Ivor-Lewis Esophagectomy respectively. The conversion rate to open surgery in the chest was 1 patient in the conventional group and none in robotic assisted group. Postoperative anastomotic leak rate occurred in 41 cases (24.1%) and 15 cases (18.8%) respectively (p = 0.342). The 30-day mortality was 2.9% (5 cases) for minimally invasive esophagectomy and none for robotic assisted minimally invasive esophagectomy. Conclusion In this single center experience. The robotic assisted approach showed non inferior to conventional video assisted surgery and conversion rates were minimal.