Video-assisted thoracoscopic esophagectomy: keynote lecture

• Published in: General thoracic and cardiovascular surgery Vol. 64; no. 7; pp. 380 - 385
• Main Authors: Cuesta, Miguel A., van der Wielen, Nicole, Straatman, Jennifer, van der Peet, Donald L.
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.07.2016; Springer Nature B.V
• Subjects: Cancer therapies; Cardiac Surgery; Cardiology; Chemotherapy; Clinical trials; Current Topics Review; Current Topics Review Article; Dissection; Esophageal cancer; Esophageal Neoplasms - surgery; Esophageal Neoplasms - therapy; Esophagectomy - methods; Gastrointestinal surgery; Humans; Infections; Laparoscopy; Laparotomy; Lymphatic system; Medicine; Medicine & Public Health; Neoadjuvant Therapy; Ostomy; Quality of Life; Quality standards; Robots; Surgeons; Surgical Oncology; Thoracic Surgery; Thoracic Surgery, Video-Assisted; Treatment Outcome; Tumors; Prone position; TIME trial; Minimally invasive esophagectomy; Thoracoscopy
• ISSN: 1863-6705; 1863-6713; 1863-6713
• DOI: 10.1007/s11748-016-0650-3

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.