Abstract Background Robot-assisted minimally invasive esophagectomy (RAMIE) is expected to allow more precise surgical manipulation than conventional thoracoscopic esophagectomy (cMIE) due to its articulated instruments and stable 3D magnified visualization. However, definitive evidence regarding its impact on treatment outcomes remains insufficient. This study aims to compare the short- and long-term outcomes of RAMIE and cMIE, particularly in patients with advanced esophageal cancer. Methods We retrospectively analyzed 189 patients who underwent cMIE and 120 patients who underwent RAMIE for esophageal cancer between April 2015 and March 2023. Propensity score matching was performed to adjust for patient background, and treatment outcomes were compared between the two groups. Results After matching, 115 patients were included in each group, with no significant differences in baseline characteristics. Postoperative complications (Clavien-Dindo grade II or higher) were comparable. The 3-year overall survival (OS) rate was 70.3% for cMIE and 78.9% for RAMIE (log-rank P = 0.048), with a hazard ratio (HR) of 0.529, showing no significant difference. However, in pStage III or higher cases, RAMIE showed significantly better OS (55.6% vs. 77.6%, log-rank P = 0.010, HR = 0.364, P = 0.0143, 95% CI: 0.162–0.817), suggesting its potential advantage in advanced esophageal cancer. Conclusion The optimal indications for cMIE and RAMIE remain unclear. However, our findings suggest that RAMIE may provide superior survival benefits in patients with advanced esophageal cancer. Further investigation is warranted to establish its long-term efficacy.
Kimura et al. (Fri,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: