Does thoracoscopic mobilisation of the oesophagus during oesophageal resection result in improved outcomes as compared to open thoracotomy?

A best evidence topic was written according to structured protocol. The question addressed was in patients undergoing trans-thoracic oesophagectomy for carcinoma of oesophagus, does a thoracoscopic mobilisation result in improved outcomes as compared to open thoracotomy. 88 papers were found using the reported search strategy of which five papers were selected as representing the best evidence to answer this question are discussed. Overall the evidence on this topic is poor with no prospective randomised controlled trials. We conclude that thoracoscopic mobilisation is a safe alternative to open resection with comparable results in overall short term morbidity and mortality rates. The thoracoscopic approach may have some benefits in terms of reduced blood loss and shorter hospital stay without compromising lymph node clearance and oncological value, but more studies are required to confirm these findings.