Universität zu Köln

Babic, Benjamin ORCID: 0000-0003-0313-6862, Schiffmann, Lars Mortimer, Fuchs, Hans Friedrich, Mueller, Dolores Thea, Schmidt, Thomas, Mallmann, Christoph, Mielke, Laura, Frebel, Antonia, Schiller, Petra ORCID: 0000-0002-9957-1465, Bludau, Marc, Chon, Seung-Hun ORCID: 0000-0002-8923-6428, Schroeder, Wolfgang and Bruns, Christiane Josephine (2022). There is no correlation between a delayed gastric conduit emptying and the occurrence of an anastomotic leakage after Ivor-Lewis esophagectomy. Surg. Endosc., 36 (9). S. 6777 - 6784. NEW YORK: SPRINGER. ISSN 1432-2218

Full text not available from this repository.

Abstract

Introduction Esophagectomy is the gold standard in the surgical therapy of esophageal cancer. It is either performed thoracoabdominal with a intrathoracic anastomosis or in proximal cancers with a three-incision esophagectomy and cervical reconstruction. Delayed gastric conduit emptying (DGCE) is the most common functional postoperative disorder after Ivor-Lewis esophagectomy (IL). Pneumonia is significantly more often in patients with DGCE. It remains unclear if DGCE anastomotic leakage (AL) is associated. Aim of our study is to analyze, if AL is more likely to happen in patients with a DGCE. Patients and methods 816 patients were included. All patients have had an IL due to esophageal/esophagogastric-junction cancer between 2013 and 2018 in our center. Intrathoracic esophagogastric end-to-side anastomosis was performed with a circular stapling device. The collective has been divided in two groups depending on the occurrence of DGCE. The diagnosis DGCE was determined by clinical and radiologic criteria in accordance with current international expert consensus. Results 27.7% of all patients suffered from DGCE postoperatively. Female patients had a significantly higher chance to suffer from DGCE than male patients (34.4% vs. 26.2% vs., p = 0.040). Pneumonia was more common in patients with DGCE (13.7% vs. 8.5%, p = 0.025), furthermore hospitalization was longer in DGCE patients (median 17 days vs. 14d, p < 0.001). There was no difference in the rate of type II anastomotic leakage, (5.8% in both groups DGCE). All patients with ECCG type II AL (n = 47; 5.8%) were treated successfully by endoluminal/endoscopic therapy. The subgroup analysis showed that ASA >= III (7.6% vs. 4.4%, p = 0.05) and the histology squamous cell carcinoma (9.8% vs. 4.7%, p = 0.01) were independent risk factors for the occurrence of an AL. Conclusion Our study confirms that DGCE after IL is a common finding in a standardized collective of patients in a high-volume center. This functional disorder is associated with a higher rate of pneumonia and a prolonged hospital stay. Still, there is no association between DGCE and the occurrence of an AL after esophagectomy. The hypothesis, that an DGCE results in a higher pressure on the anastomosis and therefore to an AL in consequence, can be refuted. DGCE is not a pathogenetic factor for an AL.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Babic, Benjamin UNSPECIFIED orcid.org/0000-0003-0313-6862 UNSPECIFIED Schiffmann, Lars Mortimer UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuchs, Hans Friedrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Dolores Thea UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Mallmann, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Mielke, Laura UNSPECIFIED UNSPECIFIED UNSPECIFIED Frebel, Antonia UNSPECIFIED UNSPECIFIED UNSPECIFIED Schiller, Petra UNSPECIFIED orcid.org/0000-0002-9957-1465 UNSPECIFIED Bludau, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Chon, Seung-Hun UNSPECIFIED orcid.org/0000-0002-8923-6428 UNSPECIFIED Schroeder, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, Christiane Josephine UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-660402
DOI:	10.1007/s00464-021-08962-5
Journal or Publication Title:	Surg. Endosc.
Volume:	36
Number:	9
Page Range:	S. 6777 - 6784
Date:	2022
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-2218
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MINIMALLY INVASIVE ESOPHAGECTOMY; DENERVATED STOMACH; PYLORIC DRAINAGE; RISK-FACTORS; RETROSPECTIVE ANALYSIS; OUTLET OBSTRUCTION; CANCER; RECONSTRUCTION; ERYTHROMYCIN; SUBSTITUTE Multiple languages Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66040