BackgroundThoracic surgeons have recognized the advantages of minimally invasive esophagectomy (MIE). However, MIE for locally advanced esophageal cancer after neoadjuvant chemoradiotherapy (NCRT) is controversial. This study aimed to nvestigate and summarise the reliability and safety of MIE after NCRT.MethodsWe retrospectively analyzed the perioperative outcomes of patients with locally advanced esophageal cancer who underwent minimally invasive esophagectomy after neoadjuvant chemoradiotherapy from January 2016 to January 2018, and compared them with patients who underwent MIE alone during the same period.ResultsIn total, 107 patients were eligible for the study. Forty-four patients underwent MIE after NCRT (CRM), and 63 patients underwent MIE alone (MA). The surgical duration (253.59 47.51 vs. 222.86 +/- 42.86min), intraoperative blood loss (164.55 +/- 109.09 vs. 146.19 +/- 112.89ml), number of lymph nodes resected (18.36 +/- 8.01 vs. 22.10 +/- 12.03), duration of the postoperative hospital stay (12.84 +/- 6.57 vs. 14.60 +/- 8.48days), postoperative intubation time (5.68 +/- 3.08 vs. 6.54 +/- 4.97days), total incidence of complications (34.10% vs. 31.7%), and R0 resection rate (95.45% vs. 96.83%) had no significant difference. The incidence of arrhythmia was higher in CRM (P<0.02). No mortality occurred postoperatively within 30days in either group.ConclusionMinimally invasive esophagectomy after neoadjuvant chemoradiotherapy is a feasible, safe, and beneficial for postoperative recovery of patients.