Comparison of robotic versus thoracoscopic repair for congenital esophageal atresia: a propensity score matching analysis

Infographic · Jan 2024 · 1 min read

In brief

Multicenter study comparing robotic versus thoracoscopic repair in 155 neonates with esophageal atresia shows robotic approach significantly reduces anastomotic leakage (4.76% vs 19.05%) and stricture rates despite longer operative time. Robotic repair allows delayed surgery without increased respiratory complications.

Robotic repair for esophageal atresia reduces anastomotic leakage (4.76% vs 19.05%) and stricture rates (15.87% vs 31.74%) compared to thoracoscopy
Robotic approach allows delayed surgery (median 8 vs 3 days) without increasing pneumonia risk in neonates with EA
Anastomotic time is significantly shorter with robotic repair (29.5 vs 40.2 min) despite longer total operative time
Unplanned readmission within 2 years is nearly halved with robotic repair (32% vs 60%) in EA patients
Propensity-matched multicenter data (126 neonates) supports robotic repair as safe, effective alternative to thoracoscopy for congenital EA

Written by the GCMD Library team from the infographic.

The infographic uses a split-panel layout with a red sidebar on the left containing study methodology icons and text. The center shows anatomical illustrations: a side-view diagram of an infant with esophageal atresia on the left, and a robotic surgical system illustration in the middle. The right side displays outcome metrics with brown arrows indicating comparative results between the two surgical approaches.

New Infographic by Dr. Jose Campos and the Chilean Society of Pediatric Surgery

"Comparison of robotic versus thoracoscopic repair for congenital esophageal atresia: a propensity score matching analysis"

Authors: Mengxin Zhang, Jinshi Huang, Wei Zhong, Xi Zhang, Ying Zhou, Shuiqing Chi, Liying Rong, Yang Zhang, Guoqing Cao, Shuai Li, Shao-Tao Tang

Full article: https://gcmd.co/3O5VQWm

Background:

Despite the rapid advancement of robotic surgery across various surgical domains, only cases of robotic repair (RR) for neonates with esophageal atresia (EA) have been reported. Comprehensive studies comparing RR and thoracoscopic repair (TR) are lacking. We aimed to compare the safety and efficacy of RR and TR for EA.

Methods:

A retrospective multicenter study was conducted on 155 EA neonates undergoing RR (79 patients) or TR (76 patients) between August 2020 and February 2023 using propensity score matching (PSM). Asymmetric port distribution and step-trocar insertion techniques were applied during RR. Demographics and surgical outcomes were compared.

Results:

After matching, 63 patients (out of 79) in RR group and 63 patients (out of 76) in TR group were included. There were no significant differences in short-term outcomes between two groups, except for longer total operative time (173.81 vs. 160.54 min; P<0.001) and shorter anastomotic time (29.52 vs. 40.21 min; P<0.001) in RR group. Compared with TR group, the RR group had older age at surgery (8.00 vs. 3.00 d; P<0.001), but a comparable pneumonia rate. More importantly, the incidence of anastomotic leakage (4.76% vs. 19.05%, P=0.013), anastomotic stricture (15.87% vs. 31.74%, P=0.036) within one year postoperatively, and unplanned readmission (32.26% vs. 60.00%, P=0.030) within two years postoperatively were lower in RR group than in TR group.

Conclusions:

RR is a technically safe and effective option for EA patients. This approach delays the age of surgery without increasing respiratory complication rates while reducing the incidence of postoperative anastomotic complications and unplanned readmission.

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