LAUSR

W ith great appreciation, we read Dr. Griffiths’s and coworker’s letter referring to our recent publication. Their main concern relates to the effect of learning curves in laparoscopic-thoracoscopic transthoracic esophagectomy (ttMIE). Although we only included high-volume institutions (>20 cases per year) with large general experience in esophageal surgery, our database undeniably involves the initial experience ttMIE of most collaborating centers. Therefore, we fully agree that learning may have played a significant role in our EsoBenchmark database – and consequently, we have discussed this in the present manuscript as we did in other related publications. It is; however, interesting that (as shown in Fig. 2 of our paper) we were not able to demonstrate a correlation regarding anastomotic leakage rates in subgroups of high (>50 cases) and lower (<50 cases) contributing centers. The second point of critique relates to a possible selection bias for cervical and intrathoracic anastomotic techniques. To