Prolonging mechanical ventilation after minimally invasive esophagectomy significantly reduces anastomotic leak rates.

• Patients on prolonged mechanical ventilation (≥24 hours) had a lower leak rate (8.08%) compared to those with non-prolonged ventilation (23.47%).
• The difference in leak rates remained significant even after matching for other variables (7.88% vs 24.71%).

This suggests extended ventilation may improve postoperative outcomes by stabilizing oxygen levels.

• Complications like pulmonary infections and pleural effusions were also reduced in the prolonged ventilation group.