Universität zu Köln

Bartella, Isabel, Fransen, Laura F. C., Gutschow, Christian A., Bruns, Christiane J., Henegouwen, Mark L. van Berge, Chaudry, M. Asif, Cheong, Edward, Cuesta, Miguel A., Van Daele, Elke, Gisbertz, Suzanne S., van Hillegersberg, Richard, Hoelscher, Arnulf, Mercer, Stuart, Moorthy, Krishna, Nafteux, Philippe, Nilsson, Magnus, Pattyn, Piet, Piessen, Guillaume, Rasanen, Jari, Rosman, Camiel, Ruurda, Jelle P., Schneider, Paul M., Sgromo, Bruno, Nieuwenhuijzen, Grard A., Luyer, Misha D. P. and Schroeder, Wolfgang (2021). Technique of open and minimally invasive intrathoracic reconstruction following esophagectomy-an expert consensus based on a modified Delphi process. Dis. Esophagus, 34 (11). CARY: OXFORD UNIV PRESS INC. ISSN 1442-2050

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Abstract

Background: In recent years, minimally invasive Ivor Lewis (IL) esophagectomy with high intrathoracic anastomosis has emerged as surgical standard of care for esophageal cancer in expert centers. Alongside this process, many divergent technical aspects of this procedure have been devised in different centers. This study aims at achieving international consensus on the surgical steps of IL reconstruction using Delphi methodology. Methods: The expert panel consisted of specialized esophageal surgeons from 8 European countries. During a two-round Delphi process, a detailed analysis and consensus on key steps of intrathoracic gastric tube reconstruction (IL esophagectomy) was performed. Results: Response rates in Delphi rounds 1 and 2 were 100% (22 of 22 experts) and 83.3% (20 of 24 experts), respectively. Three essential technical areas of intrathoracic gastric tube reconstruction were identified: first, vascularization of the gastric conduit, second, gastric mobilization, tube formation and pull-up, and third, anastomotic technique. In addition, 3 main techniques for minimally invasive intrathoracic anastomosis are currently practiced: (i) end-to-side circular stapled, (ii) end-to-side double stapling, and (iii) side-to-side linear stapled technique. The step-by-step procedural analysis unveiled common approaches but also different expert practice. Conclusion: This precise technical description may serve as a clinical guideline for intrathoracic reconstruction after esophagectomy. In addition, the results may aid to harmonize the technical evolution of this complex surgical procedure and thereby facilitate surgical training.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bartella, Isabel UNSPECIFIED UNSPECIFIED UNSPECIFIED Fransen, Laura F. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gutschow, Christian A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, Christiane J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Henegouwen, Mark L. van Berge UNSPECIFIED UNSPECIFIED UNSPECIFIED Chaudry, M. Asif UNSPECIFIED UNSPECIFIED UNSPECIFIED Cheong, Edward UNSPECIFIED UNSPECIFIED UNSPECIFIED Cuesta, Miguel A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Van Daele, Elke UNSPECIFIED UNSPECIFIED UNSPECIFIED Gisbertz, Suzanne S. UNSPECIFIED UNSPECIFIED UNSPECIFIED van Hillegersberg, Richard UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, Arnulf UNSPECIFIED UNSPECIFIED UNSPECIFIED Mercer, Stuart UNSPECIFIED UNSPECIFIED UNSPECIFIED Moorthy, Krishna UNSPECIFIED UNSPECIFIED UNSPECIFIED Nafteux, Philippe UNSPECIFIED UNSPECIFIED UNSPECIFIED Nilsson, Magnus UNSPECIFIED UNSPECIFIED UNSPECIFIED Pattyn, Piet UNSPECIFIED UNSPECIFIED UNSPECIFIED Piessen, Guillaume UNSPECIFIED UNSPECIFIED UNSPECIFIED Rasanen, Jari UNSPECIFIED UNSPECIFIED UNSPECIFIED Rosman, Camiel UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruurda, Jelle P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schneider, Paul M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sgromo, Bruno UNSPECIFIED UNSPECIFIED UNSPECIFIED Nieuwenhuijzen, Grard A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Luyer, Misha D. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-605341
DOI:	10.1093/dote/doaa127
Journal or Publication Title:	Dis. Esophagus
Volume:	34
Number:	11
Date:	2021
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1442-2050
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GASTRIC CONDUIT; OPEN-LABEL; MULTICENTER; CANCER; TUBE Multiple languages Gastroenterology & Hepatology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60534