Robot-assisted functional minimally invasive radical resection of esophageal cancer

Background: Recently, robot-assisted surgical systems have become more and more popular, but have not been reported in functional minimally invasive radical resection of esophageal cancer,which preserves the mediastinal pleura, the azygos arch, bronchial artery, and pulmonary branch of the vagus nerve. Methods: Retrospective analysis of all patients in our hospital who underwent surgery for esophageal cancer from September 2022 to February 2024. Robot-assisted functional minimally invasive esophagectomy (RAFMIE)was performed for 44 patients who were compared with 66 functional minimally invasive esophagectomy(FMIE) cases. Result: Significantly, shorter operation time was taken in RAFMIE(222.98±28.02 vs 250.45±30.25 min P ＜0.001), thoracic operation time (75.50±14.23 vs 89.59±16.34 min P ＜0.001), abdominal operation time (51.93±14.18 vs 71.75±14.85 min P ＜0.001). Both groups were equal regarding intraoperative blood loss (82.73±57.23 vs 94.55±60.19 ml, P =0.286), radical resection (R0) rate (97.73% vs 96.97%, P =0.813) and total lymph node yield (25.45±7.40 vs 21.03±7.00, P =0.013). Postoperative hospital stay (9.75±2.23 vs 10.47±2.72, P =0.402); incidence of postoperative complications(25.76% vs 20.45%, P =0.519). Conclusion: Early results suggest that RAFMIE is safe and feasible for the treatment of esophageal cancer. The operation time of RAFMIE is shorter than FMIE, and the lymph node dissection results are better. Long-term results need to be further investigated.