Esophagus : official journal of the Japan Esophageal Society最新文献

{"title":"Laparoscopic technique for performing feeding jejunostomy via the gastric tube through the round ligament of the liver in minimally invasive esophagectomy with retrosternal reconstruction.","authors":"Shun Akiyama, Norihiro Shimoike, Seiichiro Kanaya, Akira Mori, Hisahiro Hosogi","doi":"10.1007/s10388-026-01239-7","DOIUrl":"https://doi.org/10.1007/s10388-026-01239-7","url":null,"abstract":"<p><p>Enteral nutrition after esophagectomy is commonly provided via jejunostomy; however, conventional jejunostomy carries the risk of small bowel obstruction (SBO). Feeding jejunostomy via the gastric tube (FJ‑GT), especially through the round ligament of the liver (RL), has been reported to reduce the risk of SBO or catheter site infection. However, previous reports have only described open procedures. We describe a novel laparoscopic technique for performing FJ‑GT through the RL during minimally invasive esophagectomy (MIE) with retrosternal reconstruction. Through an umbilical mini-laparotomy, the specimen was extracted, and a gastric tube was created. A jejunostomy catheter was inserted 30 cm into the duodenum from the gastric antrum, fixed to the gastric wall, and covered with the omentum. After retrosternal reconstruction, the catheter was laparoscopically exteriorized through the RL. Among the 75 consecutive patients, no catheter-related complications of Clavien-Dindo grade III or higher, including SBO, were observed. This technique is feasible and applicable in MIE.</p>","PeriodicalId":520612,"journal":{"name":"Esophagus : official journal of the Japan Esophageal Society","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidental detection of cancers during population-based endoscopic gastric cancer screening in Japan.","authors":"Kensuke Uraguchi, Kenta Hamada, Naomi Matsumoto, Toshiharu Mitsuhashi, Mizuo Ando, Kenji Fujimoto, Shunsaku Hayase, Takashi Yorifuji","doi":"10.1007/s10388-026-01238-8","DOIUrl":"https://doi.org/10.1007/s10388-026-01238-8","url":null,"abstract":"<p><strong>Background: </strong>Upper gastrointestinal endoscopy traverses the full upper aerodigestive tract, unlike radiography, potentially enabling incidental detection of non-gastric malignancies. However, its population-level incidental detection rate for non-gastric upper aerodigestive tract cancers has not been systematically quantified. The aim of this study was to compare endoscopic screening with radiography and quantify detection of non-gastric upper aerodigestive tract cancers in a population-based setting.</p><p><strong>Methods: </strong>This population-based cohort study was conducted by linking the Okayama City municipal gastric cancer screening registry with the Kokuho Database (KDB) for fiscal years 2016-2021. Among 36,326 participants contributing 64,822 screening examinations (40,832 radiography; 23,990 endoscopy), diagnoses of oral cavity, pharyngeal, laryngeal, and esophageal cancer occurring within 2 months of screening were ascertained from the KDB. Generalized estimating equations with modified Poisson regression were used to estimate adjusted risk ratios (aRRs) comparing endoscopy with radiography.</p><p><strong>Results: </strong>Endoscopic screening was significantly associated with higher composite incidental detection rates for non-gastric upper aerodigestive tract cancers (95.9 vs. 34.3 per 100,000 examinations; aRR 2.94, 95% confidence interval [CI] 1.50-5.76; p = 0.002). Specifically, esophageal cancer detection was markedly higher with endoscopy (83.4 vs. 17.1 per 100,000; aRR 5.16, 95% CI 2.16-12.32; p < 0.001). No statistically significant differences were observed for oral cavity, pharyngeal, or laryngeal cancers.</p><p><strong>Conclusions: </strong>Endoscopic gastric cancer screening is associated with substantially higher incidental detection of non-gastric upper aerodigestive tract cancers, particularly esophageal cancer. These findings suggest an additional detection value for endoscopy that extends beyond its primary gastric cancer target in organized screening programs.</p>","PeriodicalId":520612,"journal":{"name":"Esophagus : official journal of the Japan Esophageal Society","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoadjuvant chemotherapy and surgery-based treatment with selective adjuvant chemotherapy for cT2N0 esophageal squamous cell carcinoma: a multicenter retrospective study.","authors":"Tomohira Takeoka, Hiroshi Miyata, Koji Tanaka, Shigeto Nakai, Takahito Sugase, Masaaki Yamamoto, Takashi Kanemura, Keijiro Sugimura, Tomoki Makino, Atsushi Takeno, Osamu Shiraishi, Masaaki Motoori, Makoto Yamasaki, Motohiro Hirao, Kazumasa Fujitani, Takushi Yasuda, Masahiko Yano, Yuichiro Doki","doi":"10.1007/s10388-026-01232-0","DOIUrl":"https://doi.org/10.1007/s10388-026-01232-0","url":null,"abstract":"<p><strong>Background: </strong>The role of neoadjuvant chemotherapy (NAC) in clinical T2N0 (cT2N0) esophageal squamous cell carcinoma (ESCC) is controversial, largely due to limited evidence and the well-recognized inaccuracy in clinical staging.</p><p><strong>Methods: </strong>We analyzed 263 patients with cT2N0 thoracic ESCC who underwent subtotal esophagectomy between 2000 and 2019. Patients were grouped into NAC plus surgery (n = 87) and upfront surgery (n = 176); 43 patients in the latter group received adjuvant chemotherapy based on pathological risk factors.</p><p><strong>Results: </strong>Clinical staging accuracy was low, with only 15.3% of patients clinically diagnosed with T2N0 confirmed as pT2N0. Downstaging to pT1N0 occurred in 23.3% of patients, while 48.3% in the upfront surgery group showed occult pathological nodal metastasis (pN +). Lymphatic (37.2% vs. 64.2%, p < 0.001) and vascular invasion rates were low in the NAC group (20.9% vs. 46.5%, p < 0.001), but residual nodal disease remained common (32.2%). Median follow-up was 59 months. Five-year overall survival (OS) and disease-free survival were comparable between NAC and upfront surgery groups (70.5% vs. 70.6%, p = 0.574; 67.8% vs. 65.8%, p = 0.817, respectively). Recurrence patterns were similar between groups. Among pN + patients in the upfront surgery cohort, adjuvant chemotherapy improved 5-year OS (72.1% vs. 58.7%, p = 0.033), with outcomes similar to pN0 patients.</p><p><strong>Conclusion: </strong>Routine NAC did not improve long-term survival compared with upfront surgery in cT2N0 ESCC. Upfront surgery followed by selective postoperative adjuvant chemotherapy in patients with pathological nodal involvement was associated with survival outcomes approaching those of pN0 patients.</p>","PeriodicalId":520612,"journal":{"name":"Esophagus : official journal of the Japan Esophageal Society","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148612222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world treatments and outcomes in metastatic and recurrent esophageal squamous cell carcinoma in Japan: a retrospective analysis using the Millennial Medical Record database.","authors":"Ken Kato, Junice Ng, Tomoyoshi Nakano, Viriya Hantrakun, See-Hwee Yeo, Xiaowei Zhang, Hiroya Takeuchi","doi":"10.1007/s10388-026-01233-z","DOIUrl":"https://doi.org/10.1007/s10388-026-01233-z","url":null,"abstract":"<p><strong>Background: </strong>Esophageal squamous cell carcinoma (ESCC) remains a significant clinical challenge in Japan. Real-world data on treatment patterns and outcomes, particularly for patients unfit for cisplatin, remain limited. This study evaluated characteristics, treatments, and outcomes of patients newly diagnosed with metastatic ESCC (mESCC) or recurrent ESCC (rESCC).</p><p><strong>Methods: </strong>A retrospective cohort analysis was conducted using the Millennial Medical Record database (December 2021-June 2024), including patients with m/rESCC. Patients receiving first-line (1 L) systemic therapy were categorized into cisplatin or non-cisplatin groups. Key outcomes included time-to-treatment discontinuation and overall survival (OS).</p><p><strong>Results: </strong>Among 155 patients, 52.3% had mESCC and 47.7% had rESCC; 31.0% received 1 L systemic therapy, 46.4% underwent surgery or radiotherapy, and 22.6% received no treatment. Among those receiving 1 L therapy, 58.3% were treated with immune checkpoint inhibitors (ICIs), either in combination with chemotherapy or alone. Non-cisplatin patients were older with greater comorbidity burden; ~33.3% receiving ICI monotherapy and 27.8% dual ICI therapy. In contrast, 56.7% of patients in the cisplatin group received a cisplatin-ICI combination. Treatment discontinuation was more frequent with cisplatin than non-cisplatin therapy (73.3% vs. 55.6%), despite longer median treatment duration (75 vs. 47 days). Twelve-month OS was higher with cisplatin than non‑cisplatin regimens (92.1% vs. 75.0%).</p><p><strong>Conclusions: </strong>In this real-world Japanese study, cisplatin-based regimens were commonly used for m/rESCC. Many patients who did not receive cisplatin had differing outcomes. This highlights the unmet need for better-tolerated alternatives for cisplatin-unfit patients with ESCC in Japan.</p>","PeriodicalId":520612,"journal":{"name":"Esophagus : official journal of the Japan Esophageal Society","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment strategies for postoperative locoregional recurrent esophageal squamous cell carcinoma after curative resection: a narrative review.","authors":"Keiichi Jingu, Rei Umezawa, Takaya Yamamoto, Noriyoshi Takahashi, Ken Harada, Yu Suzuki, Keita Kishida, So Omata, Hinako Harada, Nanae Chiba, Shinsaku Okuda, Sota Uchimi, Masato Hirano, Yushi Takahashi, Kouki Mori","doi":"10.1007/s10388-026-01234-y","DOIUrl":"https://doi.org/10.1007/s10388-026-01234-y","url":null,"abstract":"<p><p>Recurrence following curative esophagectomy remains a major clinical challenge and is associated with poor prognosis. Treatment strategies for postoperative recurrent esophageal squamous cell carcinoma must be individualized based on recurrence patterns, prior treatment history, and patient-related factors. Locoregional recurrence and oligo-recurrence in some non-regional lymph nodes may still be amenable to curative-intent therapy, including salvage surgery and definitive chemoradiotherapy (CRT). Selection of optimal treatment should consider tumor burden, performance status, and prior radiation exposure. Salvage surgery offers favorable long-term outcomes in carefully selected patients, particularly when recurrence occurs in non-dissected regions. CRT remains a central treatment strategy for unresectable disease, whereas re-irradiation after prior radiotherapy carries a substantial risk of severe toxicity and requires cautious patient selection. Advances in radiotherapy techniques, including intensity-modulated radiotherapy and particle therapy, may improve therapeutic efficacy while reducing toxicity. In parallel, systemic therapies, particularly immune checkpoint inhibitors, have expanded treatment options; however, their role in locoregional recurrence remains to be fully defined. Importantly, prognostic factors should not only be considered descriptive variables but also integrated into clinical decision-making to distinguish candidates for curative versus palliative treatment. Future strategies integrating precision oncology and multimodal approaches are expected to further improve outcomes. Prospective studies are needed to establish optimal treatment algorithms.</p>","PeriodicalId":520612,"journal":{"name":"Esophagus : official journal of the Japan Esophageal Society","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum microRNAs for the assessment of symptomatically refractory gastroesophageal reflux disease despite acid suppression.","authors":"Ryuto Yamada, Juntaro Matsuzaki, Takanori Kanai, Takahiro Ochiya, Tatsuhiro Masaoka","doi":"10.1007/s10388-026-01237-9","DOIUrl":"https://doi.org/10.1007/s10388-026-01237-9","url":null,"abstract":"<p><strong>Background: </strong>Acid suppression with proton pump inhibitors (PPIs) or a potassium-competitive acid blocker (P-CAB) is the first-line treatment for gastroesophageal reflux disease (GERD); however, a significant proportion of patients exhibit symptomatically refractory GERD. Here, we investigated whether distinct serum miRNA profiles exist in individuals with persistent symptoms despite acid suppression, given that serum miRNAs are promising biomarkers for cancer detection and various pathophysiological conditions. We also examined the relationship between anxiety/depression and serum miRNAs associated with symptomatic refractoriness.</p><p><strong>Methods: </strong>GERD patients taking PPIs/P-CAB for at least 8 weeks were enrolled and were classified into symptomatically refractory and symptomatically responsive groups using a GerdQ questionnaire. Comprehensive serum miRNA profiling was performed for all participants. Logistic LASSO/Elastic Net regression analysis was used to identify miRNAs associated with symptomatic refractoriness to PPIs/P-CAB, and a discriminant model was developed. Associations of the identified miRNAs with the presence of reflux esophagitis (RE) and items on the Hospital Anxiety and Depression Scale (HADS) were assessed.</p><p><strong>Results: </strong>A combination of four serum miRNAs (miR-4294, miR-4725-3p, miR-3679-5p, and miR-6893-5p) was able to distinguish the symptomatically refractory group from the responsive group (sensitivity, 0.83; specificity, 0.66; AUC, 0.79). This AUC was higher than that for the presence of RE. The serum levels of three of the four miRNAs were associated with items on the HADS-A subscales.</p><p><strong>Conclusions: </strong>Distinct serum miRNA profiles are associated with symptom persistence despite acid suppression, potentially reflecting neuropsychological factors. These findings may provide new insights into the complex pathophysiology of symptomatically refractory GERD.</p>","PeriodicalId":520612,"journal":{"name":"Esophagus : official journal of the Japan Esophageal Society","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radial incision and balloon dilation for benign esophageal stenosis: initial clinical experience with exploratory historical comparison.","authors":"Kotaro Shibagaki, Yusuke Takahashi, Satoshi Kotani, Shinsuke Suemitsu, Norihisa Ishimura, Shunji Ishihara","doi":"10.1007/s10388-026-01236-w","DOIUrl":"https://doi.org/10.1007/s10388-026-01236-w","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic balloon dilation (EBD) is the standard treatment for benign esophageal stenosis (BES), but restenosis is common. Although EBD with triamcinolone acetonide injection (EBD-TA) reduces restenosis, dense fibrotic stenoses often show limited distensibility. We introduced a modified endoscopic dilation technique, radial incision and balloon dilation (RIBD), which integrates longitudinal incisions with balloon dilation and adjunctive TA injection, and evaluated its initial clinical outcomes in patients with BES.</p><p><strong>Methods: </strong>This retrospective single-center study included 66 patients who underwent endoscopic treatment for BES. RIBD was introduced in 2022, and its initial clinical outcomes were assessed with historical comparison with EBD and EBD-TA. The primary outcome was restenosis. Secondary outcomes were the number of dilation sessions, refractory stenosis, and adverse events.</p><p><strong>Results: </strong>RIBD was used as the sole treatment in 15 patients and as secondary treatment in 12. Restenosis after RIBD occurred in 1/15 patients (6.7%) in the single-method group and 2/12 (16.7%) in the multiple-methods group. The median number of dilation sessions was 1 (IQR, 1-1) in both groups. No refractory stenosis or adverse events were observed after RIBD. In exploratory historical comparisons, RIBD was associated with lower restenosis rates and fewer dilation sessions than both EBD and EBD-TA.</p><p><strong>Conclusion: </strong>RIBD is a modified endoscopic dilation technique that improves the extensibility of fibrotic esophageal stenoses while minimizing deep mucosal injury, and may represent a useful treatment option in selected patients with BES.</p><p><strong>Key words: </strong>esophageal stenosis; balloon dilation; restenosis; triamcinolone acetonide; radial incision.</p>","PeriodicalId":520612,"journal":{"name":"Esophagus : official journal of the Japan Esophageal Society","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right-first bilateral transcervical and transhiatal single-port robotic esophagectomy using the da Vinci SP system.","authors":"Koshiro Ishiyama, Ryoko Nozaki, Ryota Kakuta, Shota Igaue, Eigo Akimoto, Daichi Utsunomiya, Daisuke Kurita, Yasuyuki Seto, Hiroyuki Daiko","doi":"10.1007/s10388-026-01231-1","DOIUrl":"https://doi.org/10.1007/s10388-026-01231-1","url":null,"abstract":"<p><p>Transthoracic esophagectomy remains the standard surgical approach for esophageal cancer but may be unsuitable for patients with poor pulmonary reserve. To reduce thoracic invasiveness, transcervical esophagectomy has been developed as a non-transthoracic alternative. This technique was initially established using a left cervical approach and has subsequently evolved through the adoption of bilateral transcervical approaches and the introduction of multi-port robotic systems. This article describes a right-first bilateral transcervical and transhiatal esophagectomy using the da Vinci SP system. The procedure consists of right-first and left transcervical phases followed by a transhiatal phase performed using the same single-port robotic platform. The SP system allows three articulated instruments to be deployed through a single access port, facilitating stable tracheal retraction and precise mediastinal dissection. A right-first strategy enables most upper and middle mediastinal dissection to be completed from the right side, potentially minimizing the extent of the left cervical approach.</p>","PeriodicalId":520612,"journal":{"name":"Esophagus : official journal of the Japan Esophageal Society","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical diagnostic accuracy and lymph node metastasis patterns in clinical T1bN0M0 esophageal squamous cell carcinoma: a supplementary analysis of JCOG1409.","authors":"Motoo Nomura, Hiroya Takeuchi, Masahiko Ando, Yasuhiro Tsubosa, Hirotoshi Kikuchi, Hirofumi Kawakubo, Kazuhiro Noma, Masaki Ueno, Takahiro Tsushima, Takeo Bamba, Takeo Fujita, Yoichi Hamai, Tomokazu Kakishita, Hiroyuki Daiko, Kazuo Koyanagi, Satoru Matsuda, Ken Kato, Keita Sasaki, Tetsuya Sekita, Ryunosuke Machida, Yuko Kitagawa","doi":"10.1007/s10388-026-01230-2","DOIUrl":"https://doi.org/10.1007/s10388-026-01230-2","url":null,"abstract":"<p><strong>Background: </strong>According to the results of JCOG0502, esophagectomy and chemoradiotherapy are standard treatments for cT1bN0M0 esophageal squamous cell carcinoma (ESCC). In the trial, 27.0% of patients developed pathological lymph node metastases (LNM). As imaging has advanced, diagnostic accuracy may have improved as well. This supplementary analysis of JCOG1409 aimed to clarify the clinical diagnostic accuracy, including the lymph node metastasis-positive proportion and lymph node metastasis sites, for clinical T1bN0M0 ESCC.</p><p><strong>Methods: </strong>Data from JCOG1409, which compared thoracoscopic and open esophagectomy for ESCC, were analyzed, focusing on patients with cT1bN0M0 disease. All patients underwent esophagectomy with D2 or greater lymph node dissection, and none received neoadjuvant treatment. Pathologic findings, including the pathologic tumor depth of the primary tumor, station, and frequencies of LNM, were assessed.</p><p><strong>Results: </strong>A total of 89 patients were included in this analysis. The diagnosis of pT1b was 66.3% (59/89 patients). For N-stage accuracy, 17 (19.1%) of the 89 clinical N0 patients had pathologic LNM. LNM was confined to the cervical and upper mediastinal regions in upper thoracic tumors, and to the upper mediastinal and abdominal regions in lower thoracic tumors. Conversely, middle thoracic tumors exhibited widespread multi-field LNM.</p><p><strong>Conclusion: </strong>The clinical diagnosis of T1bN0M0 is still not accurate, although the diagnostic accuracy for LNM in JCOG1409 improved compared to that in JCOG0502.</p>","PeriodicalId":520612,"journal":{"name":"Esophagus : official journal of the Japan Esophageal Society","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial experiences of the transthoracic esophagectomy for esophageal cancer via intercostal approach with the single-port robotic surgical system.","authors":"Jiyeon Kim, Seong Yong Park","doi":"10.1007/s10388-026-01206-2","DOIUrl":"10.1007/s10388-026-01206-2","url":null,"abstract":"<p><strong>Background: </strong>The robotic single-port surgical system (SPS) presents several potential advantages over conventional multiport (MP) robotic systems; however, its feasibility in esophageal cancer surgery remains unclear. This study compared the outcomes of transthoracic robotic SPS esophagectomy via an intercostal approach with conventional robotic-assisted minimally invasive esophagectomy (RAMIE).</p><p><strong>Methods: </strong>Between December 2024 and November 2025, 104 cases of MP RAMIE and 21 cases of transthoracic robotic esophagectomy via an intercostal approach using the SPS for esophageal cancer were compared.</p><p><strong>Results: </strong>Baseline demographics were comparable between groups. Although clinical stage distribution did not differ significantly, patients in the SPS group more frequently had earlier-stage disease. Neoadjuvant therapy was more commonly administered in the MP group. Operative outcomes were comparable between the two approaches. Total operation time and robotic console time did not differ significantly. Estimated blood loss was significantly lower in the SPS group. The number of dissected lymph nodes (LNs), including bilateral recurrent laryngeal nerve LN, and R0 resection rates were similar. Postoperative hospital stay and peak pain scores during admission were also comparable. Major postoperative complications (Clavien-Dindo grade ≥ III) occurred in 34.4% of patients, with no significant difference between groups. Postoperative vocal cord palsy occurred less frequently in the SPS group. One postoperative death occurred in the SPS group due to acute myocardial infarction, which was considered unrelated to the surgical procedure.</p><p><strong>Conclusions: </strong>Transthoracic robotic SPS esophagectomy via the intercostal approach was feasible and safe, and enabled sufficient upper mediastinal lymph node dissection compared to MP RAMIE.</p>","PeriodicalId":520612,"journal":{"name":"Esophagus : official journal of the Japan Esophageal Society","volume":" ","pages":"554-561"},"PeriodicalIF":3.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}