Single-port laparoscopic versus multiple-port laparoscopic combined with thoracoscopic for McKeown esophagectomy: a randomized clinical trial
In brief
Single-port laparoscopy cuts blood loss by two thirds in esophagectomy
In a randomized trial of 147 patients, the single-port approach reduced intra-operative blood loss to about 60 mL versus 200 mL with the conventional multi-port technique, and shortened the laparoscopic portion of the operation by roughly eight minutes. Pain on day three was modestly lower, while lymph-node yield, complications and recovery were similar, suggesting comparable oncologic safety with less bleeding.
- Journal
- Surgical endoscopy (Q1)
- Published
- 3 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Bo Liu, Yan-Sen Chen, Ming-Lian Qiu, Jin-Bao Xie, Zhi-Xin Huang, Jia-Zhou Xiao, et al.
- PMID
- 42693202
- DOI
- 10.1007/s00464-026-13087-8
Why clinicians should know about it
- Picked for Surgical Oncology (top studies of the week, 6 September 2026): Randomized trial of single‑ vs multi‑port esophagectomy
- Picked for Surgery (top studies of the week, 6 September 2026): Single‑port vs multi‑port laparoscopic McKeown esophagectomy RCT
Abstract
BACKGROUP: The optimal number of abdominal ports for minimally invasive McKeown esophagectomy remains debated. This study aimed to determine whether single-port laparoscopy combined with thoracoscopy yields superior perioperative outcomes compared to conventional multiport laparoscopy combined with thoracoscopy. METHODS: Between October 2021 and December 2023, 147 patients were randomly assigned to single-port or multiport laparoscopic-assisted thoracoscopic surgery. Primary outcomes included operative time, intraoperative blood loss, postoperative pain, and lymph node yield; secondary outcomes comprised complications and recovery indicators. RESULTS: Total operative time was comparable between groups (P < . 05). The single-port group exhibited significantly lower total blood loss (60(15, 110) vs. 200(50, 250) mL, P < . 001) and shorter laparoscopic time (49 (39, 57) vs. 57 (45, 76) min, P = . 03). In patients with BMI > 25 kg/m2, these advantages were more pronounced (operative time: 54 ± 7 vs. 66 ± 12 min, P < . 01; blood loss: 11 ± 5 vs. 20 ± 7 mL, P < . 001). Pain scores were lower in the single-port group on postoperative day 3 (VAS 2. 45 ± 0. 42 vs. 2. 99 ± 0. 87, P < . 001). Lymph node yield was similar between groups. Complication rates and recovery indicators did not differ significantly. CONCLUSIONS: Compared with the multiport approach, single-port laparoscopy reduces blood loss, shortens operative time, and alleviates postoperative pain without compromising oncological efficacy or safety.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.