{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T02:45:45Z","timestamp":1773369945015,"version":"3.50.1"},"reference-count":156,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T00:00:00Z","timestamp":1765065600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Minimally invasive esophagectomy (MIE) has become increasingly prominent in the surgical management of esophageal cancer (EC) over the past three decades. The adoption of minimally invasive techniques has significantly enhanced oncologic esophageal surgery by improving safety, achieving oncological radicality, preserving physiological function, and elevating the postoperative quality of life of the patients. The complexity of MIE lies in its technical nuances, which critically influence postoperative morbidity and, in severe cases, mortality, especially when complications evolve unchecked. These risks underscore the importance of meticulous surgical execution and perioperative management. The optimization of mediastinal lymphadenectomy and the reduction of procedure-related morbidity have consistently represented focal points of scientific inquiry and clinical refinement, posing a persistent challenge for esophageal surgeons. MIE is widely regarded as one of the most technically demanding procedures in oncologic surgery. Its advantages, however, are most evident in the postoperative phase, where reduced trauma and faster recovery are key benefits. Experienced surgical teams have introduced refinements to MIE protocols, aiming to optimize precision and reduce complication rates. This study aims to systematically synthesize the main technological advancements and innovations currently employed in the minimally invasive management of EC, presenting them in a structured classification designed to be both accessible and practical for specialists engaged in this domain.<\/jats:p>","DOI":"10.3390\/medicina61122176","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T09:17:36Z","timestamp":1765185456000},"page":"2176","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Advances in Minimally Invasive Esophagectomy\u2014An Overview of Recent Developments and a Novel Classification of Innovations in Treatment of Thoracic Esophageal Cancer"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0095-494X","authenticated-orcid":false,"given":"Florin","family":"Achim","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of General and Esophageal Surgery, Center of Excellence in Esophageal Surgery, Sf. Maria Clinical Hospital, 011192 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9625-785X","authenticated-orcid":false,"given":"Koji","family":"Otsuka","sequence":"additional","affiliation":[{"name":"Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa Medical University, Tokyo 142-8666, Japan"},{"name":"Digestive Disease Center, Showa Medical University Koto Toyosu Hospital, Toyosu 5-1-38, Koto-ku 135-8577, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa Medical University, Tokyo 142-8666, Japan"},{"name":"Esophageal Cancer Center, Showa Medical University Hospital, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 224-8503, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaro","family":"Asagoe","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, National Cancer Center Hospital, Tokyo 104-0045, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisuke","family":"Kurita","sequence":"additional","affiliation":[{"name":"Department of Esophageal Surgery, National Cancer Center Hospital, Tokyo 104-0045, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Constantin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of General and Esophageal Surgery, Center of Excellence in Esophageal Surgery, Sf. Maria Clinical Hospital, 011192 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silviu","family":"Constantinoiu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of General and Esophageal Surgery, Center of Excellence in Esophageal Surgery, Sf. Maria Clinical Hospital, 011192 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Mohssen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Sf. Maria Clinical Hospital, 011192 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristian","family":"Rosianu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Sf. Maria Clinical Hospital, 011192 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandru","family":"Rotariu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of General and Esophageal Surgery, Center of Excellence in Esophageal Surgery, Sf. Maria Clinical Hospital, 011192 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex-Claudiu","family":"Moraru","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of General and Esophageal Surgery, Center of Excellence in Esophageal Surgery, Sf. Maria Clinical Hospital, 011192 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Rasuceanu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of General and Esophageal Surgery, Center of Excellence in Esophageal Surgery, Sf. Maria Clinical Hospital, 011192 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dragos","family":"Predescu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of General and Esophageal Surgery, Center of Excellence in Esophageal Surgery, Sf. Maria Clinical Hospital, 011192 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,7]]},"reference":[{"key":"ref_1","unstructured":"International Agency for Research on Cancer\u2014IARC, and World Health Organization (2025, July 01). GLOBOCAN 2022. Available online: http:\/\/gco.iarc.fr\/today."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1007\/s11912-021-01153-4","article-title":"Update on Management of Squamous Cell Esophageal Cancer","volume":"24","author":"Waters","year":"2022","journal-title":"Curr. Oncol. Rep."},{"key":"ref_3","first-page":"doab061","article-title":"Short- and long-term outcomes in patients operated with total minimally invasive esophagectomy for esophageal cancer","volume":"7","author":"Hauge","year":"2021","journal-title":"Dis. 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