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Abstract
Minimally invasive approaches to esophageal resection have been shown to be feasible and safe, with outcomes similar to open esophagectomy. There are no controlled trials comparing the outcomes of minimally invasive esophagectomy (MIE) with open techniques, just a few comparative studies and many single institution series from which assessment of MIE and its present role have been made. The reported improvements from MIE approaches include reduced blood loss, time in intensive care and time in hospital. In comparative studies there is no clear reduction in respiratory complications, although larger series suggest there may be a benefit from MIE. Although MIE approaches report less lymph node retrieval compared with open extended lymphadenectomy, MIE cancer outcomes are comparable with open surgery. MIE will be a major component of the future esophageal surgeons’ armamentarium, but should continue to be carefully assessed. There is a role for multicentered studies to prospectively audit outcomes. Large numbers of patients would be required to perform randomized trials of MIE versus open resection.
Financial & competing interests disclosure
The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.
Notes
*Hand-assisted (via small incision) laparoscopic procedures included.
‡Small thoracic incisions to assist thoracoscopy or perform anastomosis included.