Abstract Background Robotic-assisted minimally invasive esophagectomy (RAMIE) has been increasingly adopted in the world. While its advantages in surgical outcomes are evident, evidence for its long-term efficacy compared to video-assisted thoracoscopic surgery (VATS) remains limited. Methods This study analyzed 574 patients with thoracic esophageal cancer who underwent RAMIE (n = 184) or VATS (n = 390) between January 2017 and December 2023. Using propensity score matching with covariates such as gender, age, PS, tumor location, cTNM stage, and preoperative therapy, 180 patients from each group were compared for short- and long-term outcomes. Results Comparing RAMIE (n = 180) and VATS (n = 180), the operative time was significantly longer for RAMIE (510 min vs. 471 min, p 0.0001), with no significant differences in R0 resection rate, intraoperative blood loss, or postoperative hospital stay. The incidence of postoperative complications (Clavien-Dindo grade ≥ 2) was similar, but pleural effusion was more frequent in the RAMIE group (9 vs. 2 cases, p = 0.026). While 2-year OS and RFS showed no overall differences, RAMIE demonstrated significantly better 2-year OS for cT4 cases (92.9% vs. 43.8%, p = 0.0163). Recurrence patterns were comparable between the two groups. Conclusion RAMIE may provide long-term benefits over VATS, particularly for cT4 esophageal cancer. Surgical techniques and future directions will be also discussed in my presentation.
Makino et al. (Fri,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: