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Background <p>Although robot-assisted minimally invasive esophagectomy (RAMIE) reportedly provides better short-term and comparable long-term outcomes compared with open esophagectomy, its long-term outcomes versus those of minimally invasive esophagectomy (MIE) remain insufficiently investigated. This multicenter retrospective cohort study aimed to investigate the perioperative safety, efficacy, and long-term survival of patients of RAMIE versus MIE for esophageal cancer.</p> Methods <p>We included patients with cStage 0-IVa thoracic esophageal cancer who underwent esophagectomy through the right thoracic cavity between January 2016 and December 2019 in six Japanese hospitals. The short- and long-term outcomes between RAMIE and MIE were compared by using propensity score matching.</p> Results <p>After matching, 268 of 396 patients were analyzed. Compared with MIE, RAMIE had a longer operative time (629 vs. 574 min, <i>p</i> &lt; 0.01), a trend toward less severe morbidity (Clavien–Dindo grade ≥ III: 18% vs. 23%), and a lower incidence (22% vs. 34%, <i>p</i> = 0.02) and mitigated severity of recurrent laryngeal nerve (RLN) palsy (<i>p</i> = 0.040). Blood loss, inhospital mortality, and the mediastinal node harvest were similar between the two techniques. The 3- and 5-year overall survival rates were 77% and 66% for RAMIE and 74% and 66% for MIE (hazard ratio [HR] 0.89; 95% confidence interval [CI] 0.57–1.37; <i>p</i> = 0.59). Relapse-free survival was also similar (3-year 64% vs. 63%; 5-year 61% vs. 59%; HR 0.87; 95% CI 0.60–1.28; <i>p</i> = 0.49).</p> Conclusions <p>RAMIE reduced the incidence and severity of RLN palsy despite requiring a longer operation time and demonstrated similar long-term outcomes to MIE.</p>

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Short- and Long-term Outcomes of Robotic versus Conventional Minimally Invasive Esophagectomy for Esophageal Cancer: A Multicenter Propensity Score-matched Cohort Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月22日

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  • Shigeru Tsunoda,
  • Hisahiro Hosogi,
  • Shohei Matsufuji,
  • Yukie Yoda,
  • Susumu Shibasaki,
  • Kenoki Ohuchida,
  • Hiroshi Okabe,
  • Tatsuto Nishigori,
  • Seiichiro Kanaya,
  • Hirokazu Noshiro,
  • Koichi Suda,
  • Ichiro Uyama,
  • Kazutaka Obama

摘要

Background

Although robot-assisted minimally invasive esophagectomy (RAMIE) reportedly provides better short-term and comparable long-term outcomes compared with open esophagectomy, its long-term outcomes versus those of minimally invasive esophagectomy (MIE) remain insufficiently investigated. This multicenter retrospective cohort study aimed to investigate the perioperative safety, efficacy, and long-term survival of patients of RAMIE versus MIE for esophageal cancer.

Methods

We included patients with cStage 0-IVa thoracic esophageal cancer who underwent esophagectomy through the right thoracic cavity between January 2016 and December 2019 in six Japanese hospitals. The short- and long-term outcomes between RAMIE and MIE were compared by using propensity score matching.

Results

After matching, 268 of 396 patients were analyzed. Compared with MIE, RAMIE had a longer operative time (629 vs. 574 min, p < 0.01), a trend toward less severe morbidity (Clavien–Dindo grade ≥ III: 18% vs. 23%), and a lower incidence (22% vs. 34%, p = 0.02) and mitigated severity of recurrent laryngeal nerve (RLN) palsy (p = 0.040). Blood loss, inhospital mortality, and the mediastinal node harvest were similar between the two techniques. The 3- and 5-year overall survival rates were 77% and 66% for RAMIE and 74% and 66% for MIE (hazard ratio [HR] 0.89; 95% confidence interval [CI] 0.57–1.37; p = 0.59). Relapse-free survival was also similar (3-year 64% vs. 63%; 5-year 61% vs. 59%; HR 0.87; 95% CI 0.60–1.28; p = 0.49).

Conclusions

RAMIE reduced the incidence and severity of RLN palsy despite requiring a longer operation time and demonstrated similar long-term outcomes to MIE.