The Enhanced Recovery After Surgery (ERAS®) program constitutes a real improvement in perioperative care. This evidence-based concept has been proven to reduce the impact of surgery on the patient, thereby decreasing potential complications. The beneficial effects have been demonstrated in different clinical situations, although they are particularly relevant for patients with multiple co-morbidities undergoing major surgery. The ERAS is, therefore, fully applicable to esophageal surgery.
Minimally-invasive surgery has been demonstrated to be an optimal approach in visceral surgery. Laparoscopy is associated with less postoperative pain, faster recovery, and shorter hospital stay. Esophagectomy is a complex operation with significant morbidity. Minimally-invasive approaches can nonetheless reduce this morbidity. Over the last years, hybrid techniques have been introduced, in which one part of the surgical procedure is laparoscopic or thoracoscopic while the other one is performed via the open approach.