SUN Xintian 1,2 , MIN Weirun 1,2 , CHEN Wenlong 1,2 , CHEN Hui¹ 1 , WANG Wenliang 1,2 , YE Zhibo 1,2 , JIN Dacheng 2 , GOU Yunjiu 1,2
  • 1. First Clinical Medical school, Gansu University of Chinese Medicine, Lanzhou, 730000, P. R. China;
  • 2. Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, 730000, P. R. China;
GOU Yunjiu, Email: gouyunjiu@163.com
Da Vinci robot; thoracoscopic-laparoscopic; esophagectomy; short-term efficacy; recurrent laryngeal nerve; Mckeown
10.7507/1007-4848.202503036
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Objective To compare the short-term outcomes of Da Vinci robot-assisted minimally invasive esophagectomy (RAMIE) and video-assisted thoracoscopic-laparoscopic minimally invasive esophagectomy (VAMIE) for esophageal cancer. Methods A retrospective analysis was conducted on the data of patients with esophageal cancer admitted to Gansu Provincial People's Hospital from January 2021 to February 2025. Based on the surgical method, patients were divided into a RAMIE group and a VAMIE group. Both groups underwent standard McKeown three-incision surgery and systematic three-field lymph node dissection. Intraoperative blood loss, number of lymph nodes dissected, postoperative recovery indicators, and complication rates were compared. Results A total of 126 patients with esophageal cancer were included, of which 109 were male and 17 were female, with an average age of (64.6±8.8) years. The RAMIE group consisted of 36 patients and the VAMIE group 90 patients. There was no statistical difference in baseline indicators such as age, sex, and body mass index between the two groups (P>0.05). The difference in operation time between the two groups was not statistically significant [305.0 (280.0, 348.0) min vs. 300.0 (268.8, 340.0) min, P=0.457]. Compared with the VAMIE group, the RAMIE group had less intraoperative blood loss [100.0 (100.0, 120.0) mL vs. 100.0 (100.0, 200.0) mL, P=0.035], more intraoperative fluid infusion [(2244.7±610.3) mL vs. (1954.4±457.9) mL, P=0.013], a higher number of lymph nodes dissected [(27.9±10.6) nodes vs. (21.3±5.1) nodes, P<0.001], and the difference in the number of lymph node dissection groups was not statistically significant [8.0 (6.0, 8.0) groups vs. 7.0 (5.0, 8.0) groups, P=0.268]. In terms of postoperative recovery indicators, compared with the VAMIE group, the RAMIE group had shorter postoperative hospital stay [12.5 (9.0, 18.0) d vs. 17.0 (14.0, 22.0) d, P＜0.001] and shorter time with tubes [9.0 (8.0, 10.0) d vs. 10.0 (9.0, 12.0) d, P=0.007]. In terms of postoperative complications, the incidence of recurrent laryngeal nerve injury in the RAMIE group was significantly lower than that in the VAMIE group (2.8% vs. 16.7%, P=0.039), there was no statistical difference in pulmonary infection, anastomosis leakage, and incision infection between the two groups (P>0.05). The total hospitalization cost of the RAMIE group was significantly higher than that of the VAMIE group (P<0.001). Conclusion RAMIE has significant advantages over VAMIE in terms of intraoperative bleeding control, the number of lymph node dissections, postoperative recovery speed, and reducing the risk of incision infection and recurrent laryngeal nerve injury, with good safety and feasibility.

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