After neoadjuvant therapy for esophageal cancer, robotic surgery more often included left recurrent laryngeal nerve (RLN) node dissection and retrieved more nodes there—but was associated with more overall complications.

• In 137 matched patients per group, RLN-node dissection was performed in 67.9% with robotics versus 53.3% with conventional minimally invasive surgery; after chemoradiotherapy, mean yield was 1.6 versus 1.0 nodes.
• Overall complications were 38.0% versus 24.8%; severe complications, length of stay and 90-day mortality did not differ significantly.

The greater nodal yield has not been shown to improve cancer outcomes. This retrospective comparison supports further study, not a change in approach.