Minimally invasive and robotic-assisted approaches for esophagectomy reduce complications.

• Reduced risk of pulmonary complications: mie (RR 0.46) and ramie (RR 0.48) outperform open and hybrid techniques.
• Significantly lower intraoperative blood loss and shorter hospital stays for mie and ramie.

These findings support selecting minimally invasive techniques for better postoperative outcomes, without compromising cancer control.

• Perioperative outcomes like anastomotic leak and mortality were comparable across all approaches.