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Generalizability of the Results and Concerns About Leakage Rates of the ICAN Trial
JAMA Surgery  (IF14.766),  Pub Date : 2021-10-20, DOI: 10.1001/jamasurg.2021.5263
Wobbe O. de Steur, Merlijn Hutteman, Henk H. Hartgrink

To the Editor With interest we have read the randomized clinical trial by van Workum et al.1 In their article, the authors show a reduction in anastomotic leakage rate from 31.7% to 12.3% with the introduction of an intrathoracic anastomosis. They conclude that “intrathoracic, as opposed to cervical, anastomosis resulted in better outcome for patients treated with transthoracic MIE [minimally invasive esophagectomy] for midesophageal to distal esophageal or gastroesophageal junction cancer.”1 Although this study is well performed and the authors have to be congratulated, we cannot fully concur with the conclusion and future recommendations in their article.