Implementation of Minimally Invasive Esophagectomy From a Randomized Controlled Trial Setting to National Practice

The previous randomized study of minimally invasive esophagectomy vs open esophagectomy (TIME trial) conducted in the Netherlands demonstrated reduced pulmonary complications and LOS with MIE.  Compared to the benefits of MIE in those selected high volume centers, national use of MIE was associated with increased overall complications, increased pulmonary complications, and increased reoperation rates.