Background: Here, we investigated the relationship between clinical parameters, including the site of surgical anastomosis and radiation dose to the anastomotic region, and anastomotic complications in esophageal cancer patients treated with trimodality therapy.
Methods: Between 2007 and 2016, esophageal cancer patients treated with trimodality therapy at a tertiary academic cancer center were identified. Patient, treatment, and outcome parameters were collected. Radiation dose to the gastric regions were extracted. Anastomotic complication was defined as leak and/or stricture. We used Fisher's exact and Wilcoxon rank-sum tests to compare the association between clinical parameters and anastomotic complications.
Results: Of 89 patients identified, the median age was 63 years, 82% (n = 73) were male, and 82% had distal (n = 47) or gastroesophageal junction (n = 26) tumors. Median follow-up was 25.8 months. Esophagectomies were performed with cervical (65%, n = 58) or thoracic anastomoses (35%, n = 31). Anastomotic complications developed in 60% (n = 53). Cervical anastomosis was associated with anastomotic complications (83%, n = 44/53, p < 0.01). Radiation to any gastric substructure was not associated with anastomotic complications (p > 0.05). In the subset of patients with distal/gastroesophageal junction tumors undergoing esophagectomy with cervical anastomosis where radiation was delivered to the future neoesophagus, 80% (n = 35/44) developed anastomotic complications. In this high-risk subgroup, radiation was not associated with anastomotic complications (p > 0.05).
Conclusions: Our analysis did not demonstrate an association between radiation dose to gastric substructures and anastomotic complications. However, it showed an association between esophagectomy with cervical anastomosis and anastomotic complications. Patients with distal/gastroesophageal junction tumors who undergo esophagectomy with cervical anastomosis have higher rates of anastomotic complications unrelated to radiation to gastric substructures.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8636205 | PMC |
| http://dx.doi.org/10.1111/1759-7714.14130 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Early Oral Feeding in Patients Undergoing Upper Gastrointestinal Surgery: A Propensity Score-matching Study.
In Vivo
December 2024
Department of Surgery, Clinical Center, Medical School, University of Pécs, Pécs, Hungary.
Background/aim: Enhanced recovery after surgery (ERAS) protocol is adopted in clinical practice worldwide, but a lack of evidence for measurable benefits after upper gastrointestinal (GI) surgeries can be detected especially regarding early oral feeding.
Patients And Methods: A propensity score-matching study was conducted at the Department of Surgery of the University of Pécs between January 2020 and December 2023. The study included patients who underwent upper GI cancer surgery and were treated according to an early oral feeding protocol (EOF).
Tight Anastomosis of the Pancreatojejunostomy During Pancreatoduodenectomy May Cause Late Acute Pancreatitis.
Anticancer Res
January 2025
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Background/aim: To investigate risk factors of late acute remnant pancreatitis after pancreatoduodenectomy (PD), we propose the use of a suturing pitch calculated based on the diameter of the main pancreatic duct and the number of sutures used in the pancreatic duct-to-mucosa anastomosis. This study aimed to determine whether the suturing pitch can predict late acute pancreatitis following PD.
Patients And Methods: This study included 142 patients who underwent elective PD.
Comparative analysis of functional end-to-end and end-to-side anastomosis in laparoscopic right hemicolectomy for colon cancer.
Surgery
December 2024
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Background: Despite advancements in laparoscopic right hemicolectomy for right-sided colon cancer, the choice between functional end-to-end anastomosis and end-to-side anastomosis remains a topic of debate. This study aimed to compare these 2 techniques in terms of postoperative complications and disease-free survival.
Methods: This retrospective analysis included 1,202 patients who underwent laparoscopic right hemicolectomy for nonmetastatic colon cancer at Samsung Medical Center between January 2007 and February 2016.
Short-Term Outcomes of a Novel Hybrid Technique, Minimally Invasive Laparoscopic and Robotic Surgery (MILAR) Using the da Vinci SP System for Gastric Cancer.
Asian J Endosc Surg
December 2024
Department of Gastric Surgery, National Cancer Center Hospital, Tokyo, Japan.
Background: Robotic surgery may have shown advantages over conventional laparoscopic surgery, but the da Vinci SP system, which utilizes a single incision, has had limited use in gastric cancer surgery. This study aims to evaluate the short-term outcomes of a novel hybrid technique, minimally invasive laparoscopic and robotic surgery (MILAR), with the da Vinci SP system for gastric cancer.
Materials And Methods: This retrospective study reviewed 23 consecutive patients who underwent gastrectomy for gastric cancer using the MILAR technique with the da Vinci SP system between May and October 2024.
Comparison of Clinical Outcomes Between Delta-Shaped and Circular Anastomoses After Laparoscopic Distal Gastrectomy.
Asian J Endosc Surg
December 2024
Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Kanagawa, Japan.
Introduction: Laparoscopic distal gastrectomy (LDG) is the standard treatment for gastric cancer, during which the laparoscopic Billroth I anastomosis technique, also known as the delta-shaped anastomosis (DA), is widely performed. This study aimed to evaluate the differences in short- and long-term symptoms between DA and traditional circular anastomosis (CA) techniques.
Methods: We retrospectively compared DA and CA procedures in patients undergoing LDG and subsequent reconstruction using the Billroth I method at the Kanagawa Cancer Center from 2017 to 2022.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!