Robotic-assisted Esophagectomy Vs Video-Assisted Thoracoscopic Esophagectomy (REVATE): Study Protocol for a Randomized Controlled Trial

Overview

Journal Trials

Publisher Biomed Central

Specialties General Medicine
Pharmacology

Date 2019 Jun 12

PMID 31182150

Citations 25

Authors

Yin-Kai Chao

Zhi-Gang Li

Yu-Wen Wen

Dae-Joon Kim

Seong-Yong Park

Yu-Ling Chang

Pieter C van der Sluis

Jelle P Ruurda

Richard van Hillegersberg

Affiliations

Soon will be listed here.

Abstract

Background: Radical lymph node dissection (LND) along the left recurrent laryngeal nerve (RLN) is surgically demanding and can be associated with substantial postoperative morbidity. The question of whether robot-assisted esophagectomy (RE) might be superior to video-assisted thoracoscopic esophagectomy (VATE) for performing LND along the RLN in patients with esophageal squamous cell carcinoma (ESCC) remains open.

Methods/design: We will conduct a multicenter, open-label, randomized controlled trial (Robotic-assisted Esophagectomy vs Video-Assisted Thoracoscopic Esophagectomy (REVATE)) enrolling patients with ESCC scheduled to undergo LND along the RLN. Patients will be randomly assigned to either RE or VATE. The primary outcome measure will be the rate of unsuccessful LND along the left RLN, which will be defined as: failure to remove lymph nodes along the left RLN (i.e., no identifiable nodes on pathology reports); or occurrence of permanent (duration > 6 months) left RLN palsy following LND. Secondary outcomes will include the number of successfully removed RLN nodes, postoperative recovery, length of hospital stay, 30-day and 90-day mortality, quality of life, and oncological outcomes.

Discussion: The REVATE study provides an opportunity to explore whether RE could facilitate LND along the left RLN-a complex surgical procedure that, as of now and with the use of VATE, remains difficult to perform and associated with a significant burden of morbidity.

Trial Registration: ClinicalTrials.gov, NCT03713749 . Registered on 22 October 2018.

Citing Articles

Evaluating Postoperative Morbidity and Outcomes of Robotic-Assisted Esophagectomy in Esophageal Cancer Treatment-A Comprehensive Review on Behalf of TROGSS (The Robotic Global Surgical Society) and EFISDS (European Federation International Society....

Vashist Y, Goyal A, Shetty P, Girnyi S, Cwalinski T, Skokowski J Curr Oncol. 2025; 32(2).

PMID: 39996872 PMC: 11854120. DOI: 10.3390/curroncol32020072.

The Current State of Robot-Assisted Minimally Invasive Esophagectomy (RAMIE): Outcomes from the Upper GI International Robotic Association (UGIRA) Esophageal Registry.

Kooij C, de Jongh C, Kingma B, van Berge Henegouwen M, Gisbertz S, Chao Y Ann Surg Oncol. 2024; 32(2):823-833.

PMID: 39496901 PMC: 11698755. DOI: 10.1245/s10434-024-16364-9.

Robot-assisted minimally invasive oesophagectomy versus thoracoscopic approach: multi-institutional study on short-term outcomes.

Chao Y, Lee J, Huang W, Lee J, Tseng Y, Lu H BJS Open. 2024; 8(4).

PMID: 39041732 PMC: 11264138. DOI: 10.1093/bjsopen/zrae063.

Multicentre randomized clinical trial on robot-assisted versus video-assisted thoracoscopic oesophagectomy (REVATE trial).

Chao Y, Li Z, Jiang H, Wen Y, Chiu C, Li B Br J Surg. 2024; 111(7).

PMID: 38960881 PMC: 11221944. DOI: 10.1093/bjs/znae143.

Technical feasibility and oncological outcomes of robotic esophagectomy compared with conventional thoracoscopic esophagectomy for clinical T3 or T4 locally advanced esophageal cancer: a propensity-matched analysis.

Daiko H, Oguma J, Ishiyama K, Kurita D, Kubo K, Kubo Y Surg Endosc. 2024; 38(7):3590-3601.

PMID: 38755464 DOI: 10.1007/s00464-024-10872-1.

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