Minimally Invasive Surgery for Esophageal Cancer;Changes over the Last Two Decade and Future Perspective

Esophagectomy with mediastinal lymphadenectomy is a standard surgical procedure for esophageal cancer treatment, however, it is highly invasive operation and has possibility of reduction the patients' quality of life( QOL). Thoracoscopic esophagectomy was introduced to reduce the surgical invasiveness since the 1990s and it has been widely performed now. Surgical procedure has been changed from left lateral decubitous position to prone position, and robot surgery or mediastinoscopic surgery has been applied currently. Many reports indicated good short term results compared to open surgery, especially reduction of the postoperative pulmonary complication. On the other hand, there is no scientific evidence of long term survival benefit, therefore, further researches are required including an ongoing phase Ⅲ randomized controlled trial( RCT)[ Japan Clinical Oncology Group( JCOG) 1409].