The prevalence of EGFR mutations in this population of NSCLC patients was 39.6% with exon 19 mutation being the most common. The observed benefit of addition of chemotherapy over TKI in EGFR mutation-positive group raises the question, can we offer the therapy of chemotherapy-TKI combination to EGFR mutation-positive lung cancer patients as shown in the present study.

Background: Oesophageal duplication cysts (ODC) are rare in adults. Complete surgical excision is the ideal treatment. Conventionally, it is performed through a thoracotomy. We aimed to study the feasibility and safety of minimally invasive surgery (MIS) in the management of ODC and briefly reviewed the available literature. Materials and Methods: A retrospective study of all adult patients with ODC diagnosed and treated at our tertiary care centre, from 2015 to 2019, was done. All patients were operated on by MIS. Their demographic, clinicopathological, radiological and surgical details and outcomes were analysed. Results: A total of six patients (four females and two males) were diagnosed to have ODC by contrast-enhanced computed tomography. The mean age was 38 ± 4.4 years. The most common presenting complaint was chest pain (50%). Upper gastrointestinal endoscopy was normal in four patients. Endoscopic ultrasound was performed in five patients. In four patients, the cyst was located in the distal third of the oesophagus. The mean size of the cysts was 5.7 ± 2.02 cm. All the patients were operated upon by video-assisted thoracoscopic surgery (VATS). There was no conversion to open surgery. The resection was complete in all but one patient. The mean duration of surgery was 143.3 ± 35 min, and the average blood loss was 58.33 ± 20.4 mL. One patient had an oesophageal staple line leak on the 9 th post-operative day. There was no mortality. The median duration of hospital stay was 7.5 days (range: 3–25 days). Conclusion: MIS is feasible and safe in the management of adult ODC.

No abstract

Oesophageal duplication cyst (ODC) is a rare congenital anomaly of the foregut. The reports of ODCs presenting in adulthood is relatively rare. Surgical excision is the ideal treatment. Traditionally, the excision is performed via a thoracotomy with its resultant morbidity. Minimally invasive surgical (MIS) approaches are feasible and can potentially reduce the postoperative discomfort and reduce the hospital stay. We aimed to study the feasibility and safety of MIS for ODC in adults. A retrospective review of all adult patients with ODCs treated in an oesophago-gastric surgery unit, between January 2015 and March 2022, was performed. All patients received MIS. The demographic, clinico-radiological, and operative details and outcomes were analysed. Nine patients (Female 7; mean age, 36.2 ± 4.4 years) were included. Chest pain was the commonest symptom (44.0%). Oesophago-gastroscopy showed normal mucosa in all patients. Endoscopic-ultrasound was performed in all except one; no cysts had atypical features. The cysts were frequently located in the distal thoracic oesophagus (78%) and the median (range) cyst size was 6.3(3.9–13.5) cm. All patients received MIS (Thoracoscopy,8; Thoraco-laparoscopic, 1); no conversion to open surgery. The techniques resection techniques were enucleation (5), stapler-assisted resection (3) or partial excision (1). The 30-day morbidity was 22.2% (Staple line leakthoracoscopic repair, 1; pleural collectionimage-guided drainage, 1). The median (range) hospital stay was 7(3–25) days and there was no mortality. MIS is feasible and safe for the management of adult ODCs and should be offered to patients, irrespective of the timing of its presentation or the location and size of the cyst.