title: Video-assisted thoracoscopic esophagectomy: keynote lecture.
abstract: Minimally invasive esophagectomy (MIE) by thoracoscopy after neoadjuvant therapy results in significant short-term advantages such as a lower incidence of pulmonary infections and a better quality of life (QoL) with the same completeness of resection. After 1 year, a better QoL is still observed for MIE in comparison with the open approach, while having the same survival. Seven issues about implementation of MIE for cancer require discussion: (1) choice of the extension of esophageal resection and use of neoadjuvant therapy; (2) reasons to approach the esophageal cancer by MIE; (3) determining the best minimally invasive approach for gastro-esophageal junction cancers; (4) implementation of evidence-based MIE; (5) standardization of the surgical anatomy of the esophagus based on MIE; (6) future lines of research of MIE; and (7) learning process. In the time of imaging-integrated surgery it is clear that the MIE approach should be increasingly implemented in all centers worldwide having an adequate volume of patients and expertise.
authors.affiliation: Department of Gastrointestinal Surgery, VU University Medical Center, De Boelelaan 1117, ZH 7F020, 1018 HV, Amsterdam, The Netherlands. ma.cuesta@vumc.nl.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Cuesta
authors.affiliation: Department of Gastrointestinal Surgery, VU University Medical Center, De Boelelaan 1117, ZH 7F020, 1018 HV, Amsterdam, The Netherlands.
authors.forename: Nicole
authors.initials: N
authors.lastname: van der Wielen
authors.affiliation: Department of Gastrointestinal Surgery, VU University Medical Center, De Boelelaan 1117, ZH 7F020, 1018 HV, Amsterdam, The Netherlands.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Straatman
authors.affiliation: Department of Gastrointestinal Surgery, VU University Medical Center, De Boelelaan 1117, ZH 7F020, 1018 HV, Amsterdam, The Netherlands.
authors.forename: Donald L
authors.initials: DL
authors.lastname: van der Peet
mesh_terms: D004938:Esophageal Neoplasms / Q000601:surgery* / Q000628:therapy; D016629:Esophagectomy / Q000379:methods*; D006801:Humans; D020360:Neoadjuvant Therapy; D011788:Quality of Life; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome
keywords: Minimally invasive esophagectomy; Prone position; TIME trial; Thoracoscopy