{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T16:14:55Z","timestamp":1785687295950,"version":"3.56.0"},"reference-count":43,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Korea-US Collaborative Research Fund (KUCRF)","award":["RS-2024-00466887"],"award-info":[{"award-number":["RS-2024-00466887"]}]},{"name":"Korea-US Collaborative Research Fund (KUCRF)","award":["RS-2024-00436472"],"award-info":[{"award-number":["RS-2024-00436472"]}]},{"name":"Korea-US Collaborative Research Fund (KUCRF)","award":["O2411541"],"award-info":[{"award-number":["O2411541"]}]},{"name":"Korea-US Collaborative Research Fund (KUCRF)","award":["K2407621"],"award-info":[{"award-number":["K2407621"]}]},{"name":"Korea-US Collaborative Research Fund (KUCRF)","award":["K2405731"],"award-info":[{"award-number":["K2405731"]}]},{"name":"Korea Health Technology R&amp;D Project through the Korea Health Industry Development Institute (KHIDI)","award":["RS-2024-00466887"],"award-info":[{"award-number":["RS-2024-00466887"]}]},{"name":"Korea Health Technology R&amp;D Project through the Korea Health Industry Development Institute (KHIDI)","award":["RS-2024-00436472"],"award-info":[{"award-number":["RS-2024-00436472"]}]},{"name":"Korea Health Technology R&amp;D Project through the Korea Health Industry Development Institute (KHIDI)","award":["O2411541"],"award-info":[{"award-number":["O2411541"]}]},{"name":"Korea Health Technology R&amp;D Project through the Korea Health Industry Development Institute (KHIDI)","award":["K2407621"],"award-info":[{"award-number":["K2407621"]}]},{"name":"Korea Health Technology R&amp;D Project through the Korea Health Industry Development Institute (KHIDI)","award":["K2405731"],"award-info":[{"award-number":["K2405731"]}]},{"name":"Korea University Guro Hospital (Korea Research-driven Hospital) grant","award":["RS-2024-00466887"],"award-info":[{"award-number":["RS-2024-00466887"]}]},{"name":"Korea University Guro Hospital (Korea Research-driven Hospital) grant","award":["RS-2024-00436472"],"award-info":[{"award-number":["RS-2024-00436472"]}]},{"name":"Korea University Guro Hospital (Korea Research-driven Hospital) grant","award":["O2411541"],"award-info":[{"award-number":["O2411541"]}]},{"name":"Korea University Guro Hospital (Korea Research-driven Hospital) grant","award":["K2407621"],"award-info":[{"award-number":["K2407621"]}]},{"name":"Korea University Guro Hospital (Korea Research-driven Hospital) grant","award":["K2405731"],"award-info":[{"award-number":["K2405731"]}]},{"name":"Korea University Medicine grant","award":["RS-2024-00466887"],"award-info":[{"award-number":["RS-2024-00466887"]}]},{"name":"Korea University Medicine grant","award":["RS-2024-00436472"],"award-info":[{"award-number":["RS-2024-00436472"]}]},{"name":"Korea University Medicine grant","award":["O2411541"],"award-info":[{"award-number":["O2411541"]}]},{"name":"Korea University Medicine grant","award":["K2407621"],"award-info":[{"award-number":["K2407621"]}]},{"name":"Korea University Medicine grant","award":["K2405731"],"award-info":[{"award-number":["K2405731"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/cancers17071052","type":"journal-article","created":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T04:58:38Z","timestamp":1742533118000},"page":"1052","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Single-Port Robot-Assisted Minimally Invasive Esophagectomy Using the Single-Port Robotic System via the Subcostal Approach: A Single-Center Retrospective Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6592-6483","authenticated-orcid":false,"given":"Jun Hee","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Guro Hospital, Korea University College of Medicine, Seoul 08308, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9632-6803","authenticated-orcid":false,"given":"Byung Mo","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Guro Hospital, Korea University College of Medicine, Seoul 08308, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyeong Hun","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Medicine, Korea University College of Medicine, Seoul 02841, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"You Jin","family":"Jang","sequence":"additional","affiliation":[{"name":"Division of Upper Gastrointestinal Surgery, Department of Surgery, Guro Hospital, Korea University College of Medicine, Seoul 08308, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7604-4729","authenticated-orcid":false,"given":"Hyun Koo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Guro Hospital, Korea University College of Medicine, Seoul 08308, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA A Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1136\/gutjnl-2022-327736","article-title":"Global burden of colorectal cancer in 2020 and 2040: Incidence and mortality estimates from GLOBOCAN","volume":"72","author":"Morgan","year":"2023","journal-title":"Gut"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Sheikh, M., Roshandel, G., McCormack, V., and Malekzadeh, R. (2023). Current Status and Future Prospects for Esophageal Cancer. Cancers, 15.","DOI":"10.3390\/cancers15030765"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1016\/j.annonc.2022.07.003","article-title":"Oesophageal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up","volume":"33","author":"Obermannova","year":"2022","journal-title":"Ann. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s00595-019-01878-7","article-title":"Recent progress in multidisciplinary treatment for patients with esophageal cancer","volume":"50","author":"Watanabe","year":"2020","journal-title":"Surg. Today"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/0960-7404(93)90052-Z","article-title":"Endoscopic subtotal oesophagectomy for cancer using the right thoracoscopic approach","volume":"1","author":"Cuschieri","year":"1993","journal-title":"Surg. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1097\/SLA.0000000000003559","article-title":"Health-related Quality of Life Following Hybrid Minimally Invasive Versus Open Esophagectomy for Patients With Esophageal Cancer, Analysis of a Multicenter, Open-label, Randomized Phase III Controlled Trial: The MIRO Trial","volume":"271","author":"Mariette","year":"2020","journal-title":"Ann. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1097\/SLA.0000000000002171","article-title":"Minimally Invasive Versus Open Esophageal Resection: Three-year Follow-up of the Previously Reported Randomized Controlled Trial: The TIME Trial","volume":"266","author":"Straatman","year":"2017","journal-title":"Ann. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1007\/s11605-011-1792-3","article-title":"Does minimally invasive esophagectomy (MIE) provide for comparable oncologic outcomes to open techniques? A systematic review","volume":"16","author":"Dantoc","year":"2012","journal-title":"J. Gastrointest. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1001\/jamasurg.2020.7081","article-title":"Five-Year Survival Outcomes of Hybrid Minimally Invasive Esophagectomy in Esophageal Cancer: Results of the MIRO Randomized Clinical Trial","volume":"156","author":"Nuytens","year":"2021","journal-title":"JAMA Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1016\/j.jtcvs.2004.02.014","article-title":"The robotic, 2-stage, 3-field esophagolymphadenectomy","volume":"127","author":"Kernstine","year":"2004","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.athoracsur.2023.11.021","article-title":"The Society of Thoracic Surgeons General Thoracic Surgery Database: 2023 Update on Outcomes and Research","volume":"117","author":"Towe","year":"2024","journal-title":"Ann. Thorac. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.jtcvs.2005.07.031","article-title":"Robotic assistance for video-assisted thoracic surgical lobectomy: Technique and initial results","volume":"131","author":"Park","year":"2006","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"302","DOI":"10.5090\/jcs.21.069","article-title":"Totally Robotic Esophagectomy","volume":"54","author":"Kang","year":"2021","journal-title":"J. Chest Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1016\/j.jtcvs.2024.03.005","article-title":"Robotic thoracic surgery using the single-port robotic system: Initial experience with more than 100 cases","volume":"168","author":"Lee","year":"2024","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"ivad026","DOI":"10.1093\/icvts\/ivad026","article-title":"Single-port plus one port subcostal robotic-assisted minimally invasive McKewon esophagectomy using the daVinci Single-Port surgical system","volume":"36","author":"Lee","year":"2023","journal-title":"Interdiscip. CardioVascular Thorac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1007\/s00423-020-02003-w","article-title":"Minimally invasive esophagectomy: Clinical evidence and surgical techniques","volume":"405","author":"Mann","year":"2020","journal-title":"Langenbeck\u2019s Arch. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2913","DOI":"10.21037\/jtd.2019.07.53","article-title":"Clinical utility of robot-assisted transthoracic esophagectomy in advanced esophageal cancer after neoadjuvant chemoradiation therapy","volume":"11","author":"Yun","year":"2019","journal-title":"J. Thorac. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jtho.2016.10.016","article-title":"Cancer of the Esophagus and Esophagogastric Junction: An Eighth Edition Staging Primer","volume":"12","author":"Rice","year":"2017","journal-title":"J. Thorac. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/SLA.0b013e3181b13ca2","article-title":"The Clavien-Dindo classification of surgical complications: Five-year experience","volume":"250","author":"Clavien","year":"2009","journal-title":"Ann. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1097\/SLA.0000000000001098","article-title":"International Consensus on Standardization of Data Collection for Complications Associated With Esophagectomy: Esophagectomy Complications Consensus Group (ECCG)","volume":"262","author":"Low","year":"2015","journal-title":"Ann. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"National Health Commission of The People\u2019s Republic of China (2022). National guidelines for diagnosis and treatment of esophageal carcinoma 2022 in China (English version). Chin. J. Cancer Res., 34, 309\u2013334.","DOI":"10.21147\/j.issn.1000-9604.2022.04.01"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"294","DOI":"10.5090\/jcs.21.065","article-title":"Robot-Assisted Thoracoscopic Esophagectomy with Total Mediastinal Lymphadenectomy: A Guide to a Systematic Approach Using the Concept of Fascial Plane Dissection","volume":"54","author":"Park","year":"2021","journal-title":"J. Chest Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.xjtc.2021.04.038","article-title":"Minimally invasive Ivor Lewis esophagectomy in 10 steps","volume":"10","author":"Harrington","year":"2021","journal-title":"JTCVS Tech."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1007\/s10388-011-0291-7","article-title":"Usefulness of blood supply visualization by indocyanine green fluorescence for reconstruction during esophagectomy","volume":"8","author":"Shimada","year":"2011","journal-title":"Esophagus"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.surg.2022.03.006","article-title":"Intrathoracic versus cervical anastomosis in esophagectomy for esophageal cancer: A meta-analysis of randomized controlled trials","volume":"172","author":"You","year":"2022","journal-title":"Surgery"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1568","DOI":"10.1016\/S0003-4975(97)00125-2","article-title":"Esophageal resection for cancer of the esophagus: Long-term function and quality of life","volume":"63","author":"McLarty","year":"1997","journal-title":"Ann. Thorac. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.jtcvs.2004.08.024","article-title":"Does esophagogastric anastomotic technique influence the outcome of patients with esophageal cancer?","volume":"129","author":"Ercan","year":"2005","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1470","DOI":"10.1007\/s00464-007-9653-6","article-title":"Endoscopic and symptomatic assessment of anastomotic strictures following esophagectomy and cervical esophagogastrostomy","volume":"22","author":"Williams","year":"2008","journal-title":"Surg. Endosc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"3297","DOI":"10.1007\/s00423-022-02706-2","article-title":"Linear- versus circular-stapled esophagogastric anastomosis during esophagectomy: Systematic review and meta-analysis","volume":"407","author":"Aiolfi","year":"2022","journal-title":"Langenbecks Arch. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1111\/j.1442-2050.2007.00792.x","article-title":"A change in clinical practice: A partially stapled cervical esophagogastric anastomosis reduces morbidity and improves functional outcome after esophagectomy for cancer","volume":"21","author":"Kondra","year":"2008","journal-title":"Dis. Esophagus"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1097\/SLA.0000000000005023","article-title":"Robot-assisted Versus Conventional Minimally Invasive Esophagectomy for Resectable Esophageal Squamous Cell Carcinoma: Early Results of a Multicenter Randomized Controlled Trial: The RAMIE Trial","volume":"275","author":"Yang","year":"2022","journal-title":"Ann. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"znae143","DOI":"10.1093\/bjs\/znae143","article-title":"Multicentre randomized clinical trial on robot-assisted versus video-assisted thoracoscopic oesophagectomy (REVATE trial)","volume":"111","author":"Chao","year":"2024","journal-title":"Br. J. Surg."},{"key":"ref_34","first-page":"ivac133","article-title":"Early postoperative pain after subxiphoid uniportal thoracoscopic major lung resection: A prospective, single- blinded, randomized controlled trial","volume":"35","author":"Chen","year":"2022","journal-title":"Interdiscip. CardioVascular Thorac. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Luo, Y., He, F., Wu, Q., Shi, H., Chen, D., and Tie, H. (2022). Feasibility of Video-Assisted Thoracoscopic Surgery via Subxiphoid Approach in Anterior Mediastinal Surgery: A Meta-Analysis. Front. Surg., 9.","DOI":"10.3389\/fsurg.2022.900414"},{"key":"ref_36","first-page":"383","article-title":"Intercostal-subcostal combined complete port-accessed video-assisted lobectomy","volume":"11","author":"Bagan","year":"2010","journal-title":"Interdiscip. CardioVascular Thorac. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"doz060","DOI":"10.1093\/dote\/doz060","article-title":"Robot-assisted minimally invasive esophagectomy (RAMIE) compared to conventional minimally invasive esophagectomy (MIE) for esophageal cancer: A propensity-matched analysis","volume":"33","author":"Tagkalos","year":"2020","journal-title":"Dis. Esophagus"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"708","DOI":"10.21037\/jtd-20-2896","article-title":"Comparison of short-term clinical outcomes between robot-assisted minimally invasive esophagectomy and video-assisted minimally invasive esophagectomy: A systematic review and meta-analysis","volume":"13","author":"Zheng","year":"2021","journal-title":"J. Thorac. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1007\/s00268-012-1538-8","article-title":"Robot-assisted thoracoscopic lymphadenectomy along the left recurrent laryngeal nerve for esophageal squamous cell carcinoma in the prone position: Technical report and short-term outcomes","volume":"36","author":"Suda","year":"2012","journal-title":"World J. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"7249","DOI":"10.1245\/s10434-021-10123-w","article-title":"Incidence of Recurrent Laryngeal Nerve Palsy in Robot-Assisted Versus Conventional Minimally Invasive McKeown Esophagectomy in Prone Position: A Propensity Score-Matched Study","volume":"28","author":"Oshikiri","year":"2021","journal-title":"Ann. Surg. Oncol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e1902","DOI":"10.1002\/rcs.1902","article-title":"Early experience with totally robotic esophagectomy for malignancy. Surgical and oncological outcomes","volume":"14","author":"Guerra","year":"2018","journal-title":"Int. J. Med. Robot. Comput. Assist. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"675","DOI":"10.21873\/anticanres.15526","article-title":"Minimally Invasive Transcervical Esophagectomy with Mediastinal Lymphadenectomy for Cancer. A Comparison with Standardized Techniques","volume":"42","author":"Davakis","year":"2022","journal-title":"Anticancer Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1055\/a-2405-2708","article-title":"Single-Port da Vinci Robot-Assisted Cervical Esophagectomy: How to Do It","volume":"72","author":"Hadzijusufovic","year":"2024","journal-title":"J. Thorac. Cardiovasc. Surg."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/7\/1052\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:57:39Z","timestamp":1760029059000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/7\/1052"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,21]]},"references-count":43,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["cancers17071052"],"URL":"https:\/\/doi.org\/10.3390\/cancers17071052","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,21]]}}}