Comparison of Respiratory function recovery after esophagectomy: a retrospective analysis of surgical approaches
- 1Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
- 2Department of Clinical Research Education, Nagoya University Graduate School of Medicine, Nagoya, Japan
Abstract
Background: Esophagectomy for patients with esophageal cancer is a highly invasive procedure that can lead to substantial postoperative pulmonary impairment. Minimally invasive approaches, such as video-assisted thoracoscopic surgery (VATS) and robot-assisted minimally invasive esophagectomy (RAMIE), have been introduced to improve postoperative outcomes. This study aimed to assess the impact of surgical approach on postoperative pulmonary function recovery.
Methods: A retrospective analysis was conducted on patients who underwent esophagectomy between 2006 and 2023. Patients were categorized into three groups: open esophagectomy (OE), VATS, and RAMIE. Pulmonary function was assessed using vital capacity (VC) and forced expiratory volume in one second (FEV1.0) at one, three, six, and 12 months postoperatively. Multivariate logistic regression was performed to identify independent factors influencing respiratory function decline.
Results: In all approaches, the VC and FEV1.0 decreased at one month postoperatively, followed by gradual recovery. Compared with OE, RAMIE showed a significantly better VC than OE at one month postoperatively (p = 0.04), whereas VATS showed a significantly better FEV1.0 at one month (p = 0.03). By 12 months, respiratory function recovery was comparable among all groups. Postoperative pulmonary complications (PPCs) were identified as a significant risk factor for long-term pulmonary function decline (p = 0.044).
Conclusions: Minimally invasive approaches, particularly RAMIE and VATS, contribute to preserving postoperative respiratory function at one month. However, respiratory function recovery is similar across all surgical techniques at one year. Preventing PPCs is crucial for improving respiratory function outcomes. Further prospective studies are needed to validate these findings and refine surgical strategies.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10388-026-01241-z.
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BibTeX
@article{sai2026comparison,
title = {{Comparison of Respiratory function recovery after esophagectomy: a retrospective analysis of surgical approaches}},
author = {Naohito Sai and Kazushi Miyata and Takahiro Imaizumi and Yasukazu Kanie and Yuki Murata and Shizuki Sugita and Atsushi Ogura and Tomoki Ebata},
journal = {Esophagus},
year = {2026},
month = sep,
doi = {10.1007/s10388-026-01241-z},
url = {https://doi.org/10.1007/s10388-026-01241-z},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Comparison of Respiratory function recovery after esophagectomy: a retrospective analysis of surgical approaches
AU - Naohito Sai
AU - Kazushi Miyata
AU - Takahiro Imaizumi
AU - Yasukazu Kanie
AU - Yuki Murata
AU - Shizuki Sugita
AU - Atsushi Ogura
AU - Tomoki Ebata
PY - 2026
DA - 2026/09/20
JO - Esophagus
DO - 10.1007/s10388-026-01241-z
UR - https://doi.org/10.1007/s10388-026-01241-z
AB - Background: Esophagectomy for patients with esophageal cancer is a highly invasive procedure that can lead to substantial postoperative pulmonary impairment. Minimally invasive approaches, such as video-assisted thoracoscopic surgery (VATS) and robot-assisted minimally invasive esophagectomy (RAMIE), have been introduced to improve postoperative outcomes. This study aimed to assess the impact of surgical approach on postoperative pulmonary function recovery. Methods: A retrospective analysis was conducted on patients who underwent esophagectomy between 2006 and 2023. Patients were categorized into three groups: open esophagectomy (OE), VATS, and RAMIE. Pulmonary function was assessed using vital capacity (VC) and forced expiratory volume in one second (FEV1.0) at one, three, six, and 12 months postoperatively. Multivariate logistic regression was performed to identify independent factors influencing respiratory function decline. Results: In all approaches, the VC and FEV1.0 decreased at one month postoperatively, followed by gradual recovery. Compared with OE, RAMIE showed a significantly better VC than OE at one month postoperatively (p = 0.04), whereas VATS showed a significantly better FEV1.0 at one month (p = 0.03). By 12 months, respiratory function recovery was comparable among all groups. Postoperative pulmonary complications (PPCs) were identified as a significant risk factor for long-term pulmonary function decline (p = 0.044). Conclusions: Minimally invasive approaches, particularly RAMIE and VATS, contribute to preserving postoperative respiratory function at one month. However, respiratory function recovery is similar across all surgical techniques at one year. Preventing PPCs is crucial for improving respiratory function outcomes. Further prospective studies are needed to validate these findings and refine surgical strategies. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10388-026-01241-z.
SN - 1612-9059
SN - 1612-9067
ER -