Robotic assisted Ivor Lewis esophagectomy in the elderly patient.

Abstract

OBJECTIVE: Robotic assisted approaches to esophagectomy have demonstrated decreased complications and length of hospitalization. We sought to examine the impact of age on outcomes in patients undergoing robotic assisted Ivor Lewis esophagectomy (RAIL). METHODS: A retrospective review of all patients undergoing RAIL from 2009-2013 was conducted. Statistical analysis was performed for the entire cohort and by stratifying patients into three age cohorts: ≤49, 50-69, ≥70. RESULTS: We identified 134 patients and found no statistically significant difference for operative time, length of hospitalization, adverse events (AE), or mortality. There was a higher median blood loss (150 cc) seen in cohorts 1 (50-600 cc) and 3 (50-400 cc) compared to cohort 2 [100 (range, 25-400) cc; P<0.01]. The overall AE rate was 10% (cohort 1), 22% (cohort 2), 35% (cohort 3), P=0.13. There were 5 (4%) leaks and 2 (1.5%) deaths, but this was not significantly different between cohorts (P=0.40, P=0.91, respectively). CONCLUSIONS: RAIL is a safe surgical technique for use in an aging patient population. There was no increased risk of AE or death in the elderly patients compared to younger patients undergoing the robotic approach.