A critical review of minimally invasive esophagectomy.

The advent of minimally invasive esophagectomy (MIE) attempts to decrease postoperative complications and mortality for this high-risk procedure. This review examines techniques in MIE, associated outcomes, and offers a critical appraisal of the literature surrounding this procedure. A Pubmed search was conducted for "minimally invasive esophagectomy" and associated synonyms. In addition, we analyze the outcomes at our institution through a prospectively maintained database. With varied techniques and utilization of different endpoints it is difficult to draw concrete conclusions from the current literature. Overall, however, there is no strong trend toward deceased mortality or decreased pulmonary complications from MIE, but there is a trend toward decreased intraoperative blood loss and shorter intensive care unit and ward stays. Until future studies are completed, MIE remains a useful tool in the armamentarium of the esophageal surgeon, and should be used not in exclusion of other approaches should patient or tumor factors dictate otherwise.