Minimally Invasive Esophagectomy In the Modern Era: Is Regional Anesthesia Still the Answer?

Ivor Lewis described his approach to resection of carcinoma of the esophagus in 1946, and his operative technique remains a mainstay of surgical treatment nearly three quarters of a century later. The integration of regional anesthesia into the perioperative management of patients undergoing open esophagectomy has been recommended based on salutary effects on outcomes, most notably postoperative pulmonary complications. With the advent of newer minimally invasive approaches, the benefits of regional blockade have been ill-defined, leading us to question the value of our long held standard.