الفهرس 
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Abstract
Esophageal carcinoma is one of the most common lethal malignancies worldwide with a very high mortality rate. Surgical resection is still representing the gold standard in managing the esophageal carcinoma patients.
The evolution of the minimally invasive surgery in this study revived hopes in managing these patients with the least morbidities while maintaining the concept of radicality.
The advantages of minimally invasive esophagectomy over open procedures include decrease in operative blood loss, length of hospital stay, pulmonary complications, and narcotic requirements.
The choice of the proper approach depends on several factors including the location of the tumor, the patient’s medical condition, prior surgical history, history of radiation therapy, the organ to be used as a replacement conduit, the limits of node dissection, and finally, the surgeon’s preference.
In this study, minimally invasive esophagectomy procedures were applied in management of esophageal carcinoma. Combined thoracoscopic and laparoscopic resection with extended two fields lymphadenectomy was done as a curative procedure.
Thoracoscopic dissection was done in the prone position using three ports. The stomach was used as a conduit in all patients. The anastomosis between the stomach and the cervical esophagus was done in the neck.
Extraction of the specimen was performed through the neck incision in most of patients.
The operative time ranged between 330 – 570 minutes with an average 430 minutes. Blood loss ranged between 100 – 500 ml with a mean of 230 ml.
Minimally invasive esophagectomy achieved the proposed targets including safety, radicality, reproducibility and achieving satisfactory postoperative outcome in the form of early ambulation, short hospital stay and proper control of pain.
MIE was expected to reduce the morbidity and mortality rate of esophageal resection when compared to conventional surgery.
Minimally invasive surgery has the advantages of better cosmetic results, reduced operative stress, postoperative immobility, and pain. These advantages are obtained by minimizing the incisions to obtain access to natural cavities. Minimally invasive approach has gained rapid acceptance and has become the gold-standard operation where external stress is higher than internal stress.