Objective:

To compare the learning curves and perioperative outcomes of synchronous versus combined inflatable mediastinoscope-laparoscopic radical esophagectomy.

Approach:

• Study Design: Retrospective cohort study involving 229 patients who underwent minimally invasive laparoscopic radical esophagectomy.
• Patient Selection: Patients were categorized into synchronous (118 cases) and combined (111 cases) groups, with 106 patients matched in each group after propensity score matching.
• Surgical Methods: Procedures were performed by a fixed surgical team with over 10 years of experience in minimally invasive esophagectomy.
• Learning Curve Assessment: Cumulative sum (CUSUM) analysis was employed to evaluate learning curves and perioperative outcomes.

Key Findings:

• Synchronous approach may reduce mechanical lung injury and inflammatory response.
• CUSUM analysis effectively identifies changes in operative performance and proficiency thresholds.
• Limited studies exist comparing learning curves of synchronous and combined approaches.

Interpretation:

Limitations:

• Retrospective nature of the study may introduce bias.
• Limited sample size after propensity score matching.

Conclusion:

The study aims to enhance understanding of the learning curves and outcomes associated with different surgical approaches for esophageal cancer.