左侧喉返神经(106recL)淋巴结清扫是一个具有挑战性的手术程序，而机器人辅助微创食管切除(RAMIE)可能具有一些优势。本研究旨在确定106recL淋巴结清扫的学习曲线。回顾性分析了2017年6月至2022年6月接受McKeown RAMIE手术的417名患者的数据。使用106recL淋巴结收获来确定学习曲线，并采用累积和(CUSUM)方法获取拐点。共有404名患者(404/417,96.9%)接受了机器人手术。根据收获的106recL淋巴结数量，绘制了CUSUM学习曲线，并分为三个阶段：第一阶段(1-75例)，第二阶段(76-240例)和第三阶段(241-404例)。每个阶段的106recL淋巴结收获数的中位数(IQR)分别为1(4)、3(6)和4(4)(p<0.001)。淋巴结清扫率从第一阶段的62.7%逐渐增加到第三阶段的82.9%(p=0.001)。总淋巴结和胸部淋巴结收获逐渐增加(p<0.001)，而手术时间(p=0.001)和失血量逐渐减少(p<0.001)。此外，总并发症(p=0.020)和喉返神经损伤(p=0.001)的发生率显著降低，术后住院时间逐渐缩短(p<0.001)。机器人106recL淋巴结清扫对于食管癌患者具有一些优势。在本研究中，随着学习曲线的提高，围手术期和临床结果显著改善。然而，需要进一步开展前瞻性研究来验证我们的结果。©2023年。外科肿瘤学会。

Left recurrent laryngeal nerve (no.106recL) lymph node dissection is a challenging procedure, and robotic-assisted minimally invasive esophagectomy (RAMIE) may have some advantages. This study aimed to determine the learning curve of no.106recL lymph node dissection.The data of 417 patients who underwent McKeown RAMIE between June 2017 and June 2022 were retrospectively analyzed. The lymph node harvest of no.106recL was used to determine the learning curve, and the cumulative sum (CUSUM) method was employed to obtain the inflection point.A total of 404 patients (404/417, 96.9%) underwent robotic surgery. Based on the number of no.106recL lymph nodes harvested, the CUSUM learning curve was mapped and divided into three phases: phase I (1‒75 cases), phase II (76‒240 cases), and phase III (241‒404 cases). The median (IQR) number of no.106recL lymph node harvests were 1 (4), 3 (6,) and 4 (4) in each phase (p < 0.001). The lymph node dissection rate gradually increased from 62.7% in phase I to 82.9% in phase III (p = 0.001). The total and thoracic lymph node harvest gradually increased (p < 0.001), whereas operation time (p = 0.001) and blood loss gradually decreased (p < 0.001). Moreover, the incidence of total complication (p = 0.020) and recurrent laryngeal nerve injury (p = 0.001) significantly decreased, and the postoperative hospital stay gradually shortened (p < 0.001).Robotic no.106recL lymph node dissection has some advantages for patients with esophageal cancer. In this study, perioperative and clinical outcomes were significantly improved over the learning curve. However, further prospective studies are required to confirm our results.© 2023. Society of Surgical Oncology.