Minimally invasive surgery for cancer of the oesophagus

Share :
Published: 5 Jul 2017
Views: 2775
Prof Christophe Mariette - Hospital Center Regional University De Lille, Lille, France

Prof Mariette talks with ecancer at ESMO GI 2017 about a phase III randomised trial, looking at minimally invasive oesophagectomy and the benefits of this procedure over open oesophagectomy. He goes on to outline the benefits of using laparoscopic gastric mobilisation and open thoracotomy over the standard opened abdominal and open thoracic approach.

The title of my presentation today will be about minimally invasive oesophagectomy, meaning that an oesophagectomy is usually associated with a higher rate of postoperative morbidity and mortality. The minimally invasive approach would help to decrease the risk of postoperative complications. So the main results are the fact that we have conducted a phase III randomised trial, that is the first one dedicated to minimally invasive oesophagectomy, looking at the role of laparoscopic gastric mobilisation with open thoracotomy compared to the standard open approach with open abdominal and open thoracic approach. Here will be presented for the first time the results of this trial, meaning that the primary endpoint, that is 30-day postoperative mortality, is significantly decreased in the minimally invasive approach group whereas the postoperative mortality would not be different between the two arms. What is new is that our long-term outcomes would also be significantly better in the minimally invasive group with better three year overall survival in the minimally invasive group when compared to the open group.

Our conclusion, and the paper is under publication, is that this phase III trial would definitely change the standard, meaning that the minimally invasive approach should be now the standard treatment for surgical oesophagectomy.

Is this procedure only being done in France?

No, now we have more than ten years of experience with this procedure and we teach a lot about this technique in France and in other [?? 1:53] countries. We have some data showing that this technique is reproducible, quite easy to perform with the same magnitude of results and should be definitely used all over the world.