Minimally Invasive Ivor Lewis Esophagectomy with Linear Stapled Anastomosis Associated with Low Leak and Stricture Rates

التفاصيل البيبلوغرافية
العنوان: Minimally Invasive Ivor Lewis Esophagectomy with Linear Stapled Anastomosis Associated with Low Leak and Stricture Rates
المؤلفون: Chukwumere Nwogu, Mark Hennon, Kristopher Attwood, Ryan M. Thomas, Moshim Kukar, Kfir Ben-David, June S. Peng, Steven N. Hochwald
المصدر: J Gastrointest Surg
سنة النشر: 2019
مصطلحات موضوعية: Male, medicine.medical_specialty, Leak, Esophageal Neoplasms, Anastomotic Leak, Constriction, Pathologic, Anastomosis, Malignancy, Article, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, medicine, Ivor lewis, Humans, Minimally Invasive Surgical Procedures, Lymph node, Aged, Retrospective Studies, Intention-to-treat analysis, business.industry, Anastomosis, Surgical, Gastroenterology, Esophageal cancer, medicine.disease, Surgery, Esophagectomy, medicine.anatomical_structure, Treatment Outcome, Respiratory failure, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, Laparoscopy, business
الوصف: BACKGROUND: Minimally invasive foregut surgery is increasingly performed for both benign and malignant diseases. We present a retrospective series of patients who underwent minimally invasive Ivor Lewis esophagectomy (MIE) with linear stapled anastomosis performed at two centers in the United States, with a focus on evaluating leak and stricture rates. METHODS: Patients treated from 2007 to 2018 were included, and data on demographics, oncologic treatment, pathology, and outcomes were analyzed. The surgical technique utilized laparoscopic and thoracoscopic access, with an intrathoracic esophagogastric anastomosis using a 6-cm linear stapled side-to-side technique. RESULTS: A total of 124 patients were included and 114 resections (91.9%) were completed in a minimally invasive fashion with a 6-cm linear stapled side-to-side anastomosis. Patients were predominantly male (90.7%) with a median age of 66.0 years and body mass index of 28.8 kg/m(2). Of 121 patients with malignancy, negative margins were obtained in 94.3% and median lymph node yield was 15 (IQR 12–22). In the intention to treat analysis, median operative time was 463 minutes (IQR 403–515), blood loss was 150 mL (IQR 100–200), and length of stay was 8 days (IQR 7–11). Postoperative complications were experienced by 64 patients (51.6%) including respiratory failure in 14 (11.3%) and pneumonia in 12 (9.7%). In patients who successfully underwent a 6-cm stapled side-to-side anastomosis, anastomotic leaks occurred in 6 patients (5.1%) without need for operative intervention, and anastomotic strictures occurred in 6 patients (5.1%) requiring endoscopic management. CONCLUSIONS: Ivor Lewis MIE with a 6-cm linear stapled anastomosis can be completed with a high technical success rate, and low rates of anastomotic leak and stricture.
تدمد: 1873-4626
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::588d9e02b2cc17436a2f81237d4c87a5
https://pubmed.ncbi.nlm.nih.gov/31317458
Rights: OPEN
رقم الانضمام: edsair.doi.dedup.....588d9e02b2cc17436a2f81237d4c87a5
قاعدة البيانات: OpenAIRE