Oesophagectomy remains a surgical operation with the potential for significant morbidity and mortality. Minimally invasive techniques have been introduced in an attempt to reduce postoperative complications and enhance patient recovery. Whether minimally invasive techniques decrease morbidity whilst maintaining the quality of the oncological resection remains a topic of debate. Globally, minimally invasive oesophagectomy (MIO) has been shown to be feasible and safe, with outcomes similar to open oesophagectomy. Assessments of the current role of MIO have largely been made based on retrospective comparative studies and many single institution series. These generally have reported that MIO reduces blood loss, shortens time in high dependency care and decreases length of hospital stay. Lymph node yields appear to be similar with a minimally invasive resection compared with open extended lymphadenectomy and MIO cancer outcomes are comparable. MIO will be a major component of the future esophageal surgeons' armamentarium, but should continue to be carefully assessed. Randomized trials comparing MIO versus open resection in oesophageal cancer are urgently needed, with only one phase III trial (TIME) having been published with the final results from a further phase III trial (MIRO trial) being keenly awaited.
Christoph Mariette, MD, PhD
Professor of Surgery - Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, Regional University Hospital Center, Place de Verdun, 59037, Lille Cedex, France
Professor Mariette is Professor of Surgery and Head of the Department of Digestive and General Surgery at the University Hospital Centre in Lille, France. He was awarded a Doctor of Medicine in 1999 and subsequently a PhD in Life and Health Sciences in 2004. In the same year, he was also accredited through Lille II University to supervise clinical and scientific research. His research work has been principally centred on fundamental, clinical and translational research projects for oesophago-gastric cancers. He is responsible for a department of clinical research and has been the principal investigator in multiple national and international randomised controlled trials, as well as being involved in a basic research group (INSERM), dedicated to these tumours. Christophe is co-ordinator of the national network FREGAT (French Esogastric Tumours working group), Secretary General of FRENCH (French Federation of Surgical Research) and co-ordinator within the Site for Integrated Research in Oncology (SIRIC) ONCOLILLE, affiliated with the National Cancer Institute in France (INCa).
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