机器人辅助微创食管切除术和传统微创食管切除术均优于开放技术。然而，很少有研究直接比较两种微创方法的结果。对来自六个医疗中心的2015年至2022年间接受微创食管切除术的食管鳞状细胞癌患者进行回顾性研究。应用逆概率治疗后比较围手术期结果该研究包括 577 名患者（机器人辅助微创食管切除术：206 名；传统微创食管切除术：371 名）。应用治疗加权的逆概率后，发现与传统微创食管切除术相比，机器人辅助微创食管切除术产生更多的纵隔淋巴结（14.86 vs 12.66，P = 0.017）。机器人辅助微创食管切除术在取回上纵隔左喉返神经淋巴结方面效果显着，平均为 1.97 个节点，而传统微创食管切除术为 1.14 个节点（P < 0.001）。与此同时，神经麻痹率显着下降（13.9% vs 22.8%，P = 0.020）。机器人辅助微创食管切除术组中，术后病程不复杂的患者比例明显更高（51.8% vs 34%，P < 0.001）。机器人辅助微创食管切除术还可以降低肺炎发生率（8.6% vs 15.2%，P = 0.041），并缩短住院时间（住院时间：16.64 天 vs 21.14 天，P = 0.007）。机器人辅助微创食管切除术在缩短住院时间方面的优势在查尔森合并症指数高的患者（≥2，平均差 8.46 天；P = 0.0069）和接受新辅助治疗的患者（平均差5.63 天；P < 0.001）。在食管鳞状细胞癌中，与传统微创食管切除术相比，使用机器人辅助微创食管切除术可减少肺炎病例，恢复更快。此外，机器人辅助微创食管切除术显着提高了沿喉返神经进行淋巴结清扫的可行性和安全性。© 作者 2024。由牛津大学出版社代表 BJS Foundation Ltd 出版。

Robot-assisted minimally invasive oesophagectomy and conventional minimally invasive oesophagectomy are superior to open techniques. However, few studies have directly compared the outcomes of the two minimally invasive approaches.A retrospective study of patients from six medical centres with oesophageal squamous cell carcinoma who underwent minimally invasive oesophagectomy between 2015 and 2022. Perioperative outcomes were compared after applying inverse probability of treatment weighting.The study included 577 patients (robot-assisted minimally invasive oesophagectomy: 206; conventional minimally invasive oesophagectomy: 371). After applying inverse probability of treatment weighting, robot-assisted minimally invasive oesophagectomy was found to yield a higher number of mediastinal nodes compared with conventional minimally invasive oesophagectomy (14.86 versus 12.66, P = 0.017). Robot-assisted minimally invasive oesophagectomy was notably effective in retrieving upper mediastinal left recurrent laryngeal nerve nodes, averaging 1.97 nodes versus 1.14 nodes harvested by conventional minimally invasive oesophagectomy (P < 0.001). This was coupled by a significant decrease in nerve palsy rates (13.9% versus 22.8%, P = 0.020). A significantly larger percentage of patients in the robot-assisted minimally invasive oesophagectomy group had an uncomplicated postoperative course (51.8% versus 34%, P < 0.001). Robot-assisted minimally invasive oesophagectomy also led to a reduction in pneumonia rates (8.6% versus 15.2%, P = 0.041) and was linked to a shorter length of stay (length of stay; 16.64 versus 21.14 days, P = 0.007). The advantage of robot-assisted minimally invasive oesophagectomy in reducing the length of stay was especially pronounced in patients with a high Charlson co-morbidity index (≥2, mean difference 8.46 days; P = 0.0069) and those who underwent neoadjuvant therapy (mean difference 5.63 days; P < 0.001).In oesophageal squamous cell carcinoma, the use of robot-assisted minimally invasive oesophagectomy led to fewer cases of pneumonia and faster recovery compared with conventional minimally invasive oesophagectomy. Additionally, robot-assisted minimally invasive oesophagectomy significantly improved the feasibility and safety of performing lymph node dissection along the recurrent laryngeal nerve.© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.