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Chylothorax is a rare complication, especially after esophageal cancer surgery. It may occur mainly in the thoracic stage of esophagectomy. The management of chylothorax is usually conservative, surgical reoperation with thoracic duct ligation being reserved for those cases refractory to that treatment. We discuss issues of diagnosis and therapeutic attitude, as evidenced by the literature, although a general consensus has not been established, most likely due to the low frequency of this complication. We emphasize the minimally invasive thoracoscopic approach, as it has been applied for two cases with this type of complication. A high rate of suspicion for thoracic duct injury should be maintained in all patients after esophageal surgery, with any pleural effusion entering the differential diagnosis of chylothorax.

Breast cancer is one of the most severe health issues globally, but the therapy advancements and the constant adaptation of treatment protocols radically changed its prognoses. This article review of the literature from a surgical perspective, thus allowing for the optimum detection and placement of its role and benefits in the surgical and oncology therapeutics. The role of surgery becomes controversial, with sometimes "pretentious" techniques, hard to quantify benefits and challenges that require a thorough assessment prior to opting for surgery. Another interesting aspect is the relative lack of guidelines for such cases with an extreme lesion plurimorphism. This is the very reason for the term "advanced breast cancer" NOT covering all possible situations, leaving room for niches difficult to frame within a therapy plan.

The treatment of esophageal cancer has become more effective due to advances in surgical techniques, multidisciplinary approach, appropriate use of neoadjuvant therapy and perioperative care at centers of excellence in esophageal surgery. Esophagectomy is one of the most complicated and demanding procedures among all gastrointestinal surgeries with a very long learning curve in which excellence can only be achieved through improvement during all the surgical career. The results of esophagectomy are related not only to the volume of cases operated but also to the experience of surgeons in the management of postoperative complications. Initially, minimally invasive esophagectomy has encountered obstacles to implementation in several centers due to the cost and complexity of esophageal cancer treatment. Several meta-analyses and clinical trials published so far support the feasibility of the minimally invasive approach, the advantages of the post-operative period and the equivalence of oncological outcomes with the open technique, which is an important step in imposing minimally invasive techniques as a standard in the treatment of esophageal cancer. In this paper, we aim to analyze recent advances in minimally invasive esophagectomy, the evolution of endoscopic surgical techniques through our personal experience and the results of studies published in the medical literature in the last years.