True, True, and Unrelated—Complications and Survival After Hybrid Minimally Invasive Esophagectomy
Menée à l'aide des données d'un essai randomisé multicentrique de phase III incluant 207 patients atteints d'un cancer de l'oesophage en France, cette étude compare l'efficacité, du point de vue de la survie globale à 5 ans et de la survie sans maladie, d'une oesophagectomie hybride mini-invasive par rapport à une oesophagectomie par voie ouverte
In this 5-year follow-up to the Multicentre Randomized Controlled Phase III (MIRO) trial, Nuytens and colleagues reported long-term outcomes of 207 patients who were randomized to undergo hybrid minimally invasive esophagectomy (HMIE; thoracotomy plus laparoscopic gastric mobilization) or open esophagectomy between 2009 to 2012 regarding survival, patterns of recurrence, and prognostic factors. Unlike other contemporary randomized clinical trials that compare an open approach with entirely minimally invasive esophagectomy (MIE), this study included open thoracotomy in both arms. Despite this, a surprising 50% reduction in major pulmonary complications was reported after HMIE (odds ratio, 0.50; 95% CI, 0.26-0.96), predominantly because of a reduction in incidence of pneumonia and major bronchial sputum that required bronchoscopy.
JAMA Surgery , éditorial, 2020