A new expanded mediastinoscopic approach shows significant benefits over traditional methods in radical esophagectomy.

• The new technique (EMLE) cut operative time by 161 minutes (329.71 vs. 168.84 min) and halved blood loss (167.84 vs. 94.87 ml) compared to inflatable mediastinoscopic (IMLE) surgery.
• Postoperative complications dropped significantly with EMLE, including a reduced risk of recurrent laryngeal nerve palsy (p < 0.001).

This technique may lead to improved patient outcomes and should be considered in surgical practice.