title: 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.
authors: 1 Moffitt Cancer Center, Tampa, FL, USA ; 2 Department of Surgery, University of Wisconsin, 600 Highlands Avenue, Madison, WI 53792, USA.
authors: Andrea
authors: A
authors: Abbott
authors: 1 Moffitt Cancer Center, Tampa, FL, USA ; 2 Department of Surgery, University of Wisconsin, 600 Highlands Avenue, Madison, WI 53792, USA.
authors: Ravi
authors: R
authors: Shridhar
authors: 1 Moffitt Cancer Center, Tampa, FL, USA ; 2 Department of Surgery, University of Wisconsin, 600 Highlands Avenue, Madison, WI 53792, USA.
authors: Sarah
authors: S
authors: Hoffe
authors: 1 Moffitt Cancer Center, Tampa, FL, USA ; 2 Department of Surgery, University of Wisconsin, 600 Highlands Avenue, Madison, WI 53792, USA.
authors: Khaldoun
authors: K
authors: Almhanna
authors: 1 Moffitt Cancer Center, Tampa, FL, USA ; 2 Department of Surgery, University of Wisconsin, 600 Highlands Avenue, Madison, WI 53792, USA.
authors: Matt
authors: M
authors: Doepker
authors: 1 Moffitt Cancer Center, Tampa, FL, USA ; 2 Department of Surgery, University of Wisconsin, 600 Highlands Avenue, Madison, WI 53792, USA.
authors: Nadia
authors: N
authors: Saeed
authors: 1 Moffitt Cancer Center, Tampa, FL, USA ; 2 Department of Surgery, University of Wisconsin, 600 Highlands Avenue, Madison, WI 53792, USA.
authors: Kenneth
authors: K
authors: Meredith
keywords: Esophageal cancer; elderly; robotic esophageal
references: Lancet. 2012 May 19;379(9829):1887-92
references: 22552194
references: J Am Coll Surg. 2014 Apr;218(4):686-92
references: 24529806
references: J Gastroenterol. 2008;43(5):345-51
references: 18592152
references: Surg Endosc. 2010 Jul;24(7):1621-9
references: 20108155
references: Ann Thorac Surg. 2001 Sep;72(3):867-71
references: 11565672
references: Br J Surg. 2010 Dec;97(12):1845-53
references: 20922782
references: Minerva Chir. 2009 Apr;64(2):135-46
references: 19365314
references: Eur J Cardiothorac Surg. 2012 Sep;42(3):430-7
references: 22345284
references: J Thorac Cardiovasc Surg. 2009 Mar;137(3):587-95; discussion 596
references: 19258071
references: Cancer. 2013 Mar 15;119(6):1149-58
references: 23303625
references: Ann Surg. 1998 Mar;227(3):357-64
references: 9527058
references: Dis Esophagus. 2010 Nov;23(8):666-9
references: 20545967
references: J Thorac Cardiovasc Surg. 2007 May;133(5):1186-92
references: 17467427
references: J Natl Compr Canc Netw. 2008 Oct;6(9):879-84
references: 18926097
references: Am Surg. 2011 Jun;77(6):675-80
references: 21679631
references: Dis Esophagus. 2012 Jul;25(5):403-9
references: 21899652
references: Cancer Control. 2013 Apr;20(2):144-50
references: 23571705
references: Ann Surg Oncol. 2010 Jun;17(6):1572-80
references: 20180031
references: Ann Surg. 2012 Jul;256(1):95-103
references: 22668811
references: Surg Endosc. 2013 Sep;27(9):3339-47
references: 23549761
references: Ann Thorac Surg. 2013 May;95(5):1741-8
references: 23500043
references: Ann Thorac Surg. 2010 Sep;90(3):900-7
references: 20732515
references: CA Cancer J Clin. 2013 Jan;63(1):11-30
references: 23335087
references: Dis Esophagus. 2013 Feb-Mar;26(2):159-66
references: 22394116
references: Cancer Control. 2013 Apr;20(2):130-7
references: 23571703
references: J Gastrointest Surg. 2013 Aug;17(8):1346-51
references: 23690208
references: J Am Coll Surg. 2011 Apr;212(4):560-6; discussion 566-8
references: 21463789
references: Ann Surg. 2000 May;231(5):635-43
references: 10767784
references: Ann Thorac Surg. 2006 Dec;82(6):2031-6; discussion 2036
references: 17126106
references: Br J Surg. 2009 Aug;96(8):878-86
references: 19591168