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Which Surgery Is Best for Esophageal Cancer? New Study Compares Options

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Approaches for esophagectomy for esophageal cancer a Network Meta-Analysis.DOI 10.1016j.ejso.2025.110529

Esophagectomy is a major surgery to remove part of the esophagus when treating esophageal cancer. But there’s more than one way to do it—and some methods may lead to fewer complications.

A new study compared four types of esophagectomy:

⦿ Open surgery (OE) – traditional method with larger cuts

⦿ Hybrid surgery (HYB) – part open, part minimally invasive

⦿ Minimally invasive surgery (MIE) – small cuts with a camera and tools

⦿ Robot-assisted surgery (RAMIE) – high-tech tools guided by a surgeon

The study found that survival rates were similar across all methods. But recovery and side effects were different.

Patients who had MIE or RAMIE had fewer lung problems after surgery than those who had open surgery. These methods are gentler on the body, which helps patients breathe better after surgery.

RAMIE had even more benefits:

⦿ It helped surgeons remove more lymph nodes, which is important for checking cancer spread.

⦿ It also had fewer re-operations, meaning fewer people needed another surgery.

On the downside, the hybrid method had a higher chance of leaks where the surgeon reconnects the digestive system. This can lead to serious complications.

While not every hospital has access to advanced robotic tools, these findings suggest that minimally invasive options—especially RAMIE—could help many patients recover better and safer.

Talk to your surgeon about which option is best for you. Your health, cancer stage, and the hospital’s experience all matter.

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Dr. Harsh J Shah

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Dr Harsh Shah - GI & HPB Oncosurgeon in India
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