Background: Robot-assisted minimally invasive esophagectomy (RAMIE) has gained global popularity. Recent randomized controlled trials have demonstrated that RAMIE results in reduced operative times and a greater number of dissected lymph nodes compared to conventional minimally invasive esophagectomy (MIE). This study provides an initial analysis of single-port (SP) robot-assisted minimally invasive esophagectomy (SRAMIE) using the SP robotic system via the subcostal approach. The primary objective is to examine perioperative outcomes of SRAMIE compared to multi-port RAMIE (MRAMIE) using the Xi robotic system and video-assisted thoracoscopic esophagectomy (VAE). Methods: In this retrospective study, patients who underwent MIE at a single center between February 2017 and December 2024 were analyzed. Patients were divided into SRAMIE (n= 17), MRAMIE (n= 13), and VAE (n= 23) groups. The primary outcome was the incidence of postoperative complications. Secondary outcomes included chest tube duration, length of postoperative hospital stay, postoperative pain levels, and 30-day mortality. Results: The SRAMIE group did not experience conversions to thoracotomy or VAE. Compared with VAE, SRAMIE resulted in significantly shorter chest tube duration (p= 0.038), shorter postoperative hospital stays (p= 0.036), and lower peak postoperative pain (p= 0.003). No significant differences were observed among the groups regarding the total operative time, number of resected lymph nodes, or incidence of postoperative complications. Conclusions: SRAMIE is a feasible approach offering advantages over VAE in recovery and postoperative pain. The comparable perioperative outcomes suggest that SRAMIE may be a viable alternative to conventional MIE, warranting further large-scale studies.
背景：机器人辅助微创食管切除术（RAMIE）已在全球范围内得到广泛应用。近期随机对照试验表明，与传统微创食管切除术（MIE）相比，RAMIE能缩短手术时间并获取更多清扫淋巴结。本研究首次对采用单孔（SP）机器人系统经肋下入路进行的单孔机器人辅助微创食管切除术（SRAMIE）进行初步分析，主要目的是比较SRAMIE与使用Xi机器人系统的多孔RAMIE（MRAMIE）及电视辅助胸腔镜食管切除术（VAE）的围手术期结局。方法：本回顾性研究分析了2017年2月至2024年12月期间在单一中心接受MIE的患者，将其分为SRAMIE组（n=17）、MRAMIE组（n=13）和VAE组（n=23）。主要观察指标为术后并发症发生率，次要指标包括胸腔引流管留置时间、术后住院时长、术后疼痛程度及30天死亡率。结果：SRAMIE组未出现中转开胸或转为VAE的情况。与VAE组相比，SRAMIE组胸腔引流管留置时间显著缩短（p=0.038）、术后住院时间更短（p=0.036）、术后疼痛峰值更低（p=0.003）。各组在总手术时间、淋巴结清扫数量及术后并发症发生率方面均无显著差异。结论：SRAMIE是一种可行的术式，在术后恢复和疼痛控制方面优于VAE。其围手术期结局与传统MIE相当，表明SRAMIE可能成为常规MIE的可行替代方案，值得开展更大规模研究进一步验证。
肿瘤(癌症)患者之家