Esophageal cancer is a rare cancer of the esophagus often caused by poorly controlled acid reflux or excessive smoking. Esophagectomy is a surgical procedure for the partial or complete removal of the esophagus and is routinely used as a treatment for esophageal cancer. However, open esophagectomy is associated with postoperative complications. Hybrid minimally invasive esophagectomy is emerging as a safer alternative, but the theory lacks evidence. This study aims to evaluate the safety of hybrid minimally invasive esophagectomy in patients with esophageal cancer.

This multicenter, open-label, randomized, controlled trial included 207 patients aged 18-75 years with resectable middle or lower esophagus cancer. The patients were randomly assigned in a 1:1 ratio to hybrid esophagectomy (n=103) or open esophagectomy (n=104). The primary outcome was intra- or post-operative complications of grade II or higher.

Of 207 patients, 110 reported a total of 312 serious adverse events. 37 patients (36%) in the hybrid-procedure group and 67 (64%) in the open-procedure group had a major intraoperative or postoperative complication. A total of 18 patients (18%) in the hybrid group and 31 patients (30%) in the open group experienced a major pulmonary complication.

The findings suggested that hybrid minimally invasive esophagectomy resulted in a lower occurrence of intraoperative and postoperative major complications, as compared to open esophagectomy.

Ref: https://www.nejm.org/doi/full/10.1056/NEJMoa1805101