Fransen, Laura F. C., Berkelmans, Gijs H. K., Asti, Emanuele, Henegouwen, Mark I. van Berge, Berlth, Felix, Bonavina, Luigi, Brown, Andrew, Bruns, Christiane, van Daele, Elke, Gisbertz, Suzanne S., Grimminger, Peter P., Gutschow, Christian A., Hannink, Gerjon ORCID: 0000-0001-9526-3775, Holscher, Arnulf H., Kauppi, Juha, Lagarde, Sjoerd M., Mercer, Stuart, Moons, Johnny, Nafteux, Philippe, Nilsson, Magnus, Palazzo, Francesco, Pattyn, Piet, Raptis, Dimitri A., Rasanen, Jari, Rosato, Ernest L., Rouvelas, Ioannis ORCID: 0000-0003-0774-1904, Schmidt, Henner M., Schneider, Paul M., Schroder, Wolfgang, van der Sluis, Pieter C., Wijnhoven, Bas P. L., Nieuwenhuijzen, Grard A. P. and Luyer, Misha D. P. (2021). The Effect of Postoperative Complications After Minimally Invasive Esophagectomy on Long-term Survival An International Multicenter Cohort Study. Ann. Surg., 274 (6). S. E1129 - 9. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1528-1140

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Abstract

Background: Esophagectomy is a technically challenging procedure. associated with significant morbidity. The introduction of minimally invasive esophagectomy (MIE) has reduced postoperative morbidity. Objective: Although the short-term effect on complications is increasingly being recognized, the impact on long-term survival remains unclear. This study aims to investigate the association between postoperative complications following MIE and long-term survival. Methods: Data were collected from the EsoBenchmark Collaborative composed by 13 high-volume, expert centers routinely performing MIE. Patients operated between June 1, 2011 and May 31, 2016 were included. Complications were graded using the Clavien-Dindo (CD) classification. To correct for short-term effects of postoperative complications on mortality, patients who died within 90 days postoperative were excluded. Primary endpoint was 5-year overall survival. Results: A total of 915 patients were included with a mean follow-up time of 30.8 months (standard deviation 17.9). Complications occurred in 542 patients (59.2%) of which 50.2% had a CD grade >= III complication [ie, (re)intervention, organ dysfunction, or death]. The incidence of anastomotic leakage (AL) was 135 of 915 patients (14.8%) of which 84 patients were classified as a CD grade >= III. Multivariable analysis showed a significantly deteriorated long-term survival in all patients with AL [hazard ratio (HR) 1.68.95% confidence interval (CI) 1.25-2.24]. This inverse relation was most distinct when AL was scored as a CD grade >= III (HR 1.83, 95% CI 1.30-2.58). For all other complications, no significant association with long-term survival was found. Conclusion: The occurrence and severity of AL, but not overall complications, after MIE negatively affect long-term survival of esophageal cancer patients.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Fransen, Laura F. C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berkelmans, Gijs H. K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Asti, EmanueleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Henegouwen, Mark I. van BergeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berlth, FelixUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bonavina, LuigiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brown, AndrewUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bruns, ChristianeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van Daele, ElkeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gisbertz, Suzanne S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grimminger, Peter P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gutschow, Christian A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hannink, GerjonUNSPECIFIEDorcid.org/0000-0001-9526-3775UNSPECIFIED
Holscher, Arnulf H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kauppi, JuhaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lagarde, Sjoerd M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mercer, StuartUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Moons, JohnnyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nafteux, PhilippeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nilsson, MagnusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Palazzo, FrancescoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pattyn, PietUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Raptis, Dimitri A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rasanen, JariUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rosato, Ernest L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rouvelas, IoannisUNSPECIFIEDorcid.org/0000-0003-0774-1904UNSPECIFIED
Schmidt, Henner M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schneider, Paul M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schroder, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van der Sluis, Pieter C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wijnhoven, Bas P. L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nieuwenhuijzen, Grard A. P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Luyer, Misha D. P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-604459
DOI: 10.1097/SLA.0000000000003772
Journal or Publication Title: Ann. Surg.
Volume: 274
Number: 6
Page Range: S. E1129 - 9
Date: 2021
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Place of Publication: PHILADELPHIA
ISSN: 1528-1140
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ANASTOMOTIC LEAK; SURGICAL COMPLICATIONS; CANCER RECURRENCE; RESECTION; IMPACT; OUTCOMES; ADENOCARCINOMA; CHEMOTHERAPY; ESOPHAGUS; MORBIDITYMultiple languages
SurgeryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60445

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