In the past 15 years, minimally invasive esophageal resection (MIE) has become increasingly common and has been performed in most teaching hospitals in the United States to reduce the overall mortality and complication rates associated with traditional open esophagectomy for esophageal cancer. The majority of the literature suggests that the MIE group has a shorter hospital stay with a lower incidence of pulmonary complications and incisional infections. There is a lack of multicenter, large data studies. Therefore, Dr. Sihag et al. from Massachusetts General Hospital conducted a retrospective study using the American College of Chest Physicians (STS) national database, which was published in the December 2015 issue of Ann Thorac Surg. The study included 3780 patients with lower and middle esophageal cancer who underwent esophagectomy between 2008 and 2011, 93% of whom were white, and 1014 who received MIE, including 214 patients who underwent the transesophageal fissure pathway and 800 patients who underwent the Ivor-Lewis pathway, and analyzed the patients’ prognosis at 30 days postoperatively using nonparametric tests. The results of the study showed no significant differences between the MIE combination and the open-heart surgery group (OE group) in terms of preoperative underlying disease, intestinal fibrosis, preoperative chemotherapy, and preoperative pulmonary function, and overall postoperative complications and mortality were similar in both groups. The MIE group had a longer operative time (443.0 minutes versus 312.0 minutes) and a shorter hospital stay (9.0 days versus 10.0 days), but patients in the MIE group were more likely to undergo reoperation (9.9% versus 4.4%) and had a higher incidence of pus-filled chest (4.1% versus 1.8%). 14.1%) and a higher chance of intestinal obstruction (4.5% vs. 2.2%). These results were confirmed by propensity score matching analysis. Dr. Sihag et al. concluded that the early results from the STS national database led to the conclusion that MIE is a safe procedure with similar complication and mortality rates compared with open-heart surgery, but did not conclude that MIE reduces postoperative pulmonary-related complications. Notably, only 2 centers with more than 20 annual MIE procedures were included in this study, with most institutions having between 1 and 10 procedures per year from 2009 to 2011, but the results were similar for both large and small centers, which the authors speculate may be due to the larger centers undertaking resident training and more invasive Ivor-ewis resections. The longer operative times and higher incidence of reoperations reflect the learning curve of the physicians. Therefore, the authors believe it will also be important to review the MIE experience over the next 3-5 years, from which additional conclusions about the value of MIE applications may be drawn.