title: Minimally invasive surgery for esophageal cancer: review of the literature and institutional experience.
abstract: BACKGROUND
  Esophageal cancer represents a major public health problem in the world. Several minimally invasive esophagectomy (MIE) techniques have been described and represent a safe alternative for the surgical management of esophageal cancer in selected centers with high volume and surgeons experienced in minimally invasive procedures.
  
  
  METHODS
  The authors reviewed the most recent and largest studies published in the medical literature that reported the outcomes for MIE techniques.
  
  
  RESULTS
  In larger series, MIE has proven to be equivalent in postoperative morbidity and mortality to the open esophagectomy. However, MIE has been associated with less blood loss, reduced postoperative pain, decreased time in the intensive care unit, and shortened length of hospital stay compared with the conventional open approaches. Despite limited data, no significant difference in survival stage for stage has been observed between open esophagectomy and MIE.
  
  
  CONCLUSIONS
  The myriad of MIE techniques complicates the debate for defining the optimal surgical approach for the treatment of esophageal cancer. Randomized controlled trials comparing MIE with conventional open esophagectomy are needed to clarify the ideal procedure with the lowest postoperative morbidity, best quality of life after surgery, and long-term survival.
authors.affiliation: Gastrointestinal Tumor Program, H Lee Moffitt Cancer Center, Tampa, FL 33612, USA.
authors.forename: Maki
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Jill M
authors.initials: JM
authors.lastname: Weber
authors.forename: Richard C
authors.initials: RC
authors.lastname: Karl
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Meredith
mesh_terms: D016063:Blood Loss, Surgical; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D010149:Postoperative Pain; D015203:Reproducibility of Results; D015996:Survival Rate; D016896:Treatment Outcome