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Updated: Jan 9, 2026
Surgical Robot-Assisted Transanal Specimen Extraction Radical Sigmoidectomy Without an Auxiliary Abdominal Incision
Published on: June 13, 2025
Surgical Outcomes of Robotic, Minimally Invasive, and Open Esophagectomy After Neoadjuvant Therapy: a Propensity
Jiahuang Hong1, Peiyuan Wang1,2,3, Junpeng Lin1
1Department of Thoracic Oncology Surgery, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
Background:
This study compared surgical outcomes among robot-assisted minimally invasive esophagectomy (RAMIE), minimally invasive esophagectomy (MIE), and open esophagectomy (OE) in patients with esophageal squamous cell carcinoma (ESCC) after neoadjuvant therapy (NAT).
Patients And Methods:
After 1:1:1 propensity score matching (PSM) of 667 eligible patients (n = 56 per group), we compared lymph node (LN) yield, postoperative outcomes, survival, and subgroup analysis by tumor location.
Results:
After PSM, RAMIE achieved higher total LN yield than MIE (45.4 versus 36.3, P = 0.003) and OE (30.1, P < 0.001), particularly in the upper mediastinum (2R/2L/4L and 8U), subcarinal (7), cervical (1R), and perigastric stations (all P < 0.05). Recurrent laryngeal nerve (RLN) palsy was lower with RAMIE versus MIE (8.9% versus 26.8%, P = 0.041) and OE (28.6%, P = 0.023). Hospital stay was shorter for RAMIE versus MIE (9 versus 12 days, P = 0.001) and OE (15 days, P < 0.001). Most postoperative outcomes showed no intergroup differences. Both RAMIE and MIE were associated with better overall survival (OS) and disease-free survival (DFS) versus OE (hazard ratio [HR] 0.39-0.46; P < 0.05), with no significant difference between them. Exploratory analyses suggested that this association was more apparent for upper/middle tumors.
Conclusions:
For NAT-treated resectable ESCC, RAMIE offers more extensive lymphadenectomy extent (higher LN yield) and safety (lower RLN palsy, shorter hospitalization) over MIE/OE. Both minimally invasive techniques showed better survival than OE and support their use after NAT, with a relatively stronger signal for upper/middle tumors.
