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Introduction <p>Despite being highly invasive, esophagectomy remains the mainstay of treatment for early- and intermediate-stage esophageal cancer. With the advancement of minimally invasive techniques, single-port thoraco-laparoscopic esophagectomy has been increasingly applied in clinical practice, offering advantages in terms of improved cosmetic outcomes, reduced postoperative pain, and enhanced recovery. However, the procedure is technically demanding. In addition, the traditional posterior mediastinal route for reconstruction is associated with a relatively high risk of complications, whereas reconstruction via the substernal route may significantly reduce cardiopulmonary morbidity.</p> Objective <p>To evaluate the short-term outcomes of uniportal thoracoscopic and single-incision plus one port laparoscopic minimally invasive esophagectomy combined with direct retrosternal approach for radical esophagectomy.</p> Methods and analysis <p>The clinical data of 60 patients who underwent uniportal thoracoscopic and single-incision plus one port laparoscopic minimally invasive esophagectomy combined with direct retrosternal approach for radical esophagectomy between January 2024 and February 2025 were retrospectively analyzed. Perioperative indicators and postoperative follow-up data were recorded in detail.</p> Results <p>All surgeries were successfully completed with no conversion to open thoracotomy or laparotomy, and no perioperative deaths occurred. The mean operative time was 209.35 ± 28.57&#xa0;min, the mean intraoperative blood loss was 64.17 ± 20.53 mL, and the mean number of lymph nodes dissected was 32.35 ± 11.51. The visual analog scale (VAS) scores for pain at postoperative were 2.20 ± 0.99. The average length of hospital stay was 7.92 ± 2.11 days. Ten patients developed postoperative complications, with a complication rate of 16.67%.</p> Conclusion <p>Uniportal thoracoscopic and single-incision plus one port laparoscopic minimally invasive esophagectomy combined with direct retrosternal approach is a safe and feasible technique for esophageal cancer, with potential advantages in terms of cosmetic outcomes and reduced postoperative incisional pain.</p>

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Uniportal thoracoscopic and single-incision plus one port laparoscopic esophagectomy with direct vision retrosternal reconstruction for esophageal cancer a single center retrospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月30日

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  • Ruirong Lin,
  • Yijin Lin,
  • Weikun Su,
  • Guibin Weng,
  • Lin Chen,
  • Weimin Fang,
  • Jiarong Zhang

摘要

Introduction

Despite being highly invasive, esophagectomy remains the mainstay of treatment for early- and intermediate-stage esophageal cancer. With the advancement of minimally invasive techniques, single-port thoraco-laparoscopic esophagectomy has been increasingly applied in clinical practice, offering advantages in terms of improved cosmetic outcomes, reduced postoperative pain, and enhanced recovery. However, the procedure is technically demanding. In addition, the traditional posterior mediastinal route for reconstruction is associated with a relatively high risk of complications, whereas reconstruction via the substernal route may significantly reduce cardiopulmonary morbidity.

Objective

To evaluate the short-term outcomes of uniportal thoracoscopic and single-incision plus one port laparoscopic minimally invasive esophagectomy combined with direct retrosternal approach for radical esophagectomy.

Methods and analysis

The clinical data of 60 patients who underwent uniportal thoracoscopic and single-incision plus one port laparoscopic minimally invasive esophagectomy combined with direct retrosternal approach for radical esophagectomy between January 2024 and February 2025 were retrospectively analyzed. Perioperative indicators and postoperative follow-up data were recorded in detail.

Results

All surgeries were successfully completed with no conversion to open thoracotomy or laparotomy, and no perioperative deaths occurred. The mean operative time was 209.35 ± 28.57 min, the mean intraoperative blood loss was 64.17 ± 20.53 mL, and the mean number of lymph nodes dissected was 32.35 ± 11.51. The visual analog scale (VAS) scores for pain at postoperative were 2.20 ± 0.99. The average length of hospital stay was 7.92 ± 2.11 days. Ten patients developed postoperative complications, with a complication rate of 16.67%.

Conclusion

Uniportal thoracoscopic and single-incision plus one port laparoscopic minimally invasive esophagectomy combined with direct retrosternal approach is a safe and feasible technique for esophageal cancer, with potential advantages in terms of cosmetic outcomes and reduced postoperative incisional pain.