Long-Term Survival and Perioperative Outcomes of Single-Port Thoracoscopic Esophagectomy for Esophageal Squamous Cell Carcinoma: A Retrospective Analysis

Background This study aimed to evaluate the long-term survival outcomes and perioperative safety of single-port thoracoscopic minimally invasive esophagectomy (SPTE) for esophageal squamous cell carcinoma (ESCC). Methods A retrospective cohort study was conducted on 330 patients who underwent SPTE at a single institution between July 2018 and September 2023. Perioperative data, complications, and survival outcomes were analyzed. Overall survival (OS) and progression-free survival (PFS) were calculated using Kaplan-Meier analysis. Results The cohort consisted of 250 men and 80 women, with a mean age of 62.52 years. The R0 resection rate was 96.1%. The mean number of lymph nodes harvested was 30.9 ± 10.7. Major postoperative complications included pulmonary infection (13.9%) and anastomotic leakage (3.0%). There were no cases of postoperative bleeding, and the reoperation rate was 0.3%. The median follow-up was 30 months. The 1-, 3-, and 5-year OS rates were 96.5%, 85.7%, and 76.9%, respectively, and the corresponding PFS rates were 90.3%, 80.9%, and 75.4%. Conclusions SPTE may be a safe and feasible technique for ESCC in our single-center experience, associated with high rates of radical resection, adequate lymphadenectomy, low perioperative morbidity, and encouraging long-term survival outcomes. However, given the single-arm, retrospective design of this study, these findings should be interpreted as descriptive and exploratory rather than comparative. Further prospective, multi-institutional studies with matched control groups are warranted to confirm these results and better define the clinical role of SPTE.