Annals of surgical oncology
October 11, 2026 · via Europe PMC
Robotic versus Conventional Minimally Invasive Esophagectomy for Resectable Esophageal Cancer After Neoadjuvant Therapy: A Dual-Center Retrospective Study.
Shen T, Li Y, He W, Zhang Y, Li C, Han Y, Wang C, Li H
AI summary — for doctors, generated from the abstract only
Robotic esophagectomy after neoadjuvant therapy had comparable perioperative safety on most measures to conventional minimally invasive surgery but more overall complications, while achieving better lymph node dissection at one station.
What was studied
Dual-center retrospective study of consecutive esophageal cancer patients having minimally invasive esophagectomy after neoadjuvant chemoradiotherapy or immunochemoradiotherapy (2020-2025), compared robotic versus conventional approach after 1:1 propensity matching (137 per group).
Key findings
- Left recurrent laryngeal nerve node dissection was more frequent with robotic surgery (67.9% vs 53.3%).
- Overall complications were higher with robotic surgery (38.0% vs 24.8%).
- Operating time, pathological complete response, severe complications, stay, readmission and 90-day mortality did not differ significantly.
Clinical relevance
Surgeons choosing between platforms should weigh improved nodal clearance against a signal of more complications, especially in programs still on the learning curve.
Who should care
Limitations
Retrospective and matched only on preoperative variables, so unmeasured confounding and surgeon expertise could bias results; no long-term oncologic outcomes are reported in the abstract.
Robotic esophagectomy appears safe in experienced hands but advantages are unproven until randomized data exist.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
OBJECTIVES
Data on robot-assisted minimally invasive esophagectomy (RAMIE) after neoadjuvant therapy, particularly after neoadjuvant immunochemoradiotherapy, remain scarce. This study compares the perioperative outcomes of RAMIE versus conventional minimally invasive esophagectomy (MIE) in patients with resectable esophageal cancer after neoadjuvant therapy.
METHODS
We conducted a dual-center, retrospective study of consecutive patients with esophageal cancer who underwent MIE after neoadjuvant chemoradiotherapy or neoadjuvant immunochemoradiotherapy between 2020 and 2025. Propensity score matching was applied based on preoperative variables. Perioperative outcomes were analyzed.
RESULTS
After 1:1 propensity score matching, 137 patients were allocated to each group. The RAMIE group demonstrated a higher rate of left recurrent laryngeal nerve lymph node dissection (67.9% vs. 53.3%, p = 0.02) and yielded more lymph nodes in this station after neoadjuvant chemoradiotherapy (mean 1.6 vs. 1.0, p = 0.02). However, RAMIE was associated with a higher overall incidence of postoperative complications (38.0% vs. 24.8%, p = 0.03). No significant differences were observed in operation time, pathological complete response rate, severe complications, length of stay, 30-day readmission, or 90-day mortality.
CONCLUSIONS
In expert hands, RAMIE achieves perioperative safety comparable to that with MIE after neoadjuvant therapy and offers a superior ability to dissect critical lymph node stations. This technical advantage establishes RAMIE as a viable and promising surgical option, warranting further prospective investigation in randomized trials.
DOI
10.1245/s10434-026-20729-7
PMID
42860495
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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