Comparisons of short-term outcomes between robot-assisted and thoraco-laparoscopic esophagectomy with extended two-field lymph node dissection for resectable thoracic esophageal squamous cell carcinoma

Esophagectomy with extended lymphadenectomy remains a mainstay of curative treatment for patients with localized esophageal squamous cell carcinoma (ESCC). The traditional open transthoracic procedure is the standard surgery for esophageal cancer (1-4). However, the video-assisted thoracoscopic surgery, with less surgical trauma, blood loss, postoperative complications, and shorter hospital stay, has been gradually recognized as a more feasible surgical procedure for esophageal cancer (3,5-7). Also, the long-term oncologic outcomes of thoraco-laparoscopic minimally invasive esophagectomy (TLMIE) were found to be equivalent to standard open surgery (4,8,9). However, the TLMIE is limited by a two-dimensional view and the reduced freedom of movements, which may disable delicate dissections of the esophagus and lymph nodes, especially in salvage surgery after definitive chemoradiotherapy or surgery following neo-adjuvant therapies