Minimally invasive transthoracic esophagectomy: pushing the boundaries to improve surgical outcomes
Improving outcomes after major oncologic procedures remains a paramount goal for most health systems. Improvements in patient selection through updated risk assessment tools, more accurate preoperative staging, better definition of perioperative therapies and advances in adjuvant antineoplastic therapies are all tools that have contributed to superior long-term outcomes for patients. Despite these improvements, some surgical procedures remain associated with significant perioperative morbidity and mortality. Esophagectomy is certainly one of these procedures. Esophagectomies are associated with a morbidity ranging from 40–80% (including Clavien-Dindo II and above), and a 30-day mortality ranging from 2% to 6% (1). However, it has been hypothesized that recent advances in minimally invasive surgical techniques have improved surgical outcomes.