RAILE-EEA in our institution suggests a safe, effective, and reproducible alternative with satisfactory postoperative outcomes for the treatment of esophageal cancer. It provided good local control, adequate lymphadenectomy, low morbidity, and low 90-day operative mortality.

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Introduction Postoperative delirium is a common complication after major surgical procedures and affects outcomes and long‐term survival. We identified factors associated with postoperative delirium in patients undergoing esophagectomy. Methods Retrospective cohort analysis of 378 patients undergoing esophagectomy. We examined the association between postoperative delirium (DSM‐V) criteria with respect to baseline variables and postoperative complications. Results Postoperative delirium was diagnosed in 64 (16.93%) patients and associated with increasing age (P < .05), chronic obstructive pulmonary disease (P = .07), pneumonia (P = .01), transfusion intraoperatively or within 72 hours of surgery (P < .001), and sepsis (P = .001). Unplanned intubation and increased length of stay (median, 14 days) were significant in patients with delirium (P = .001 and P < .001, respectively). In a secondary analysis, surgical technique and operative approach were associated with delirium. Modified McKeown (three‐hole) esophagectomy was twice more likely to develop delirium compared with Ivor Lewis (odds ratio [OR], 2.09; 95% confidence interval [CI], 1.03‐4.23). The strongest association was found between delirium and open techniques (thoracotomy and laparotomy) as compared with minimally invasive techniques (thoracoscopy and laparoscopy) (OR, 2.66; 95% CI, 1.22‐5.76). Survival was similar between both groups. Conclusions Postoperative delirium is common and associated with complications following esophagectomy. Identification of predisposing factors such as age and pre‐existing pulmonary diseases and proper selection of surgical treatment may reduce delirium and improve surgical outcomes.