Robotic oesophagectomy took more nodes in a randomised trial; survival is still to come

The edition in brief

A phase 3 trial at four European high-volume centres randomised 218 patients with oesophageal or junctional adenocarcinoma to robot-assisted or conventional minimally invasive oesophagectomy; the robotic arm yielded more lymph nodes (median 36 vs 32) with similar complications, though survival data are only at one year. A propensity-matched cohort of 452 patients from two pancreatic centres found that adding radiotherapy to neoadjuvant chemotherapy was associated with far higher R0 and node-negative rates but no difference in event-free or overall survival. A systematic review linked laparoscopic resection with permanent stoma to more clinical parastomal hernias (RR 1.89), on very low certainty evidence. Ten years of NSQIP data on 231,048 non-elective cholecystectomies show falling mortality and complications but organ-space infection more than doubling. The pearl covers stoma-site planning before an elective laparoscopic resection.