39 THE OUTCOMES OF MESENTERIC EXCISION FOR ESOPHAGEAL CANCER SURGERY

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Masazumi Sakaguchi ◽  
Hisahiro Hosogi ◽  
Yukinari Tokoro ◽  
Daisuke Yagi ◽  
Seiichiro Kanaya
Keyword(s):  
Esophageal Cancer ◽  
Survival Rate ◽  
Clinical Stage ◽  
Disease Free Survival ◽  
Dorsal Side ◽  
Cancer Surgery ◽  
R0 Resection ◽  
Invasive Esophagectomy ◽  
Esophageal Cancer Surgery ◽  
Mesenteric Excision

Abstract   We reported the esophagus, trachea, recurrent laryngeal nerves (RLNs), and regional lymph nodes are contained in a common compartment, which we named mesotracheoesophagus. We believe complete resection of the mesotracheoesophagus is ‘mesenteric excision’ for esophageal cancer, which is the fundamental principle of intestinal cancer surgery. Since June 2011, we have performed minimal invasive esophagectomy (MIE) based on this concept. This study was aimed to evaluate outcomes of our MIE. Methods We performed a retrospective study of patients with esophageal cancer who underwent MIE at our hospital between June 2011 and March 2019. Procedure First, the dorsal side of the esophagus was dissected along a dissectable layer recognized outside the mesotracheoesophagus. After complete mobilization of the dorsal side of the esophagus, the trachea and RLNs were released from the mesotracheoesophagus and the rest of the fat tissue was dissected for radical LN dissection in the upper mediastinum. Results We identified consecutive 151 eligible patients. The median age was 68 year-old (IQR 35–83) and 117 patients were male. Tumor location was Ce:Ut:Mt:Lt:Ae = 1:12:67:58:13. Histologic cell-type was squamous cell carcinoma (SqCC):adenocarcinoma = 142:9. The clinical stage (TNM 8th edition) was I:II:III:IVa = 45:39:56:2 and I:IIB:III:IVA = 2:1:5:1 in patients with SqCC and in those with adenocarcinoma, respectively. R0 resection was performed in all patients. The Clavian-Dindo classification grade III and higher RLN paralysis rate was 7.3% and the pneumonia 5.3%. The mortality rate was 1.3%. Three-year disease free survival rate was 62.3%. Three-year overall survival rate was 71.7%. Conclusion The outcomes of mesenteric excision for esophageal cancer surgery were acceptable. Video https://www.dropbox.com/s/y1lm3uurr4t86vq/2020%20ISDE%20Abstract.mov?dl=0.

Esophageal cancer surgery in Greece during the era of the financial crisis

2020 ◽  
Author(s):  
Dimitrios Schizas ◽  
Konstantinos S Mylonas ◽  
Natasha Hasemaki ◽  
Efstratia Mpaili ◽  
Vasileia Ntomi ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Financial Crisis ◽  
Gastroesophageal Junction ◽  
Disease Free Survival ◽  
Circular Stapler ◽  
Cancer Surgery ◽  
International Standards ◽  
R0 Resection ◽  
Time Of Surgery ◽  
Esophageal Cancer Surgery

Summary The aim of this study is to describe outcomes of esophageal cancer surgery in a quaternary upper gastrointestinal (GI) center in Athens during the era of the Greek financial crisis. We performed a retrospective analysis of patients that underwent esophagectomy for esophageal or gastroesophageal junction (GEJ) cancer at an upper GI unit of the University of Athens, during the period January 2004–June 2019. Time-to-event analyses were performed to explore trends in survival and recurrence. A total of 146 patients were identified. Nearly half of the patients (49.3%) underwent surgery during the last 4 years of the financial crisis (2015–2018). Mean age at the time of surgery was 62.3 ± 10.3 years, and patients did not present at older ages during the recession (P = 0.50). Most patients were stage III at the time of surgery both prior to the recession (35%) and during the financial crisis (39.8%, P = 0.17). Ivor–Lewis was the most commonly performed procedure (67.1%) across all eras (P = 0.06). Gastric conduit was the most common form of GI reconstruction (95.9%) following all types of surgery (P < 0.001). Pre-recession anastomoses were usually performed using a circular stapler (65%). Both during (88.1%) and following the recession (100%), the vast majority of anastomoses were hand-sewn. R0 resection was achieved in 142 (97.9%) patients. Anastomosis technique did not affect postoperative leak (P = 0.3) or morbidity rates (P = 0.1). Morbidity rates were not significantly different prior to (25%), during (46.9%), and after (62.5%) the financial crisis, P = 0.16. Utilization of neoadjuvant chemotherapy (26.9%, P = 0.90) or radiation (8.4%, P = 0.44) as well as adjuvant chemotherapy (54.8%, P = 0.85) and irradiation (13.7%, P = 0.49) was the same across all eras. Disease-free survival (DFS) and all-cause mortality rates were 41.2 and 47.3%, respectively. Median DFS and observed survival (OS) were 11.3 and 22.7 months, respectively. The financial crisis did not influence relapse (P = 0.17) and survival rates (P = 0.91). The establishment of capital controls also had no impact on recurrence (P = 0.18) and survival (P = 0.94). Austerity measures during the Greek financial crisis did not influence long-term esophageal cancer outcomes. Therefore, achieving international standards in esophagectomy may be possible in resource-limited countries when centralizing care.

scholarly journals Mesenteric excision for esophageal cancer surgery: based on the concept of mesotracheoesophagus

2018 ◽  
Vol 7 (4) ◽  
pp. 117-120 ◽  
Author(s):  
Shin Akagawa ◽  
Hisahiro Hosogi ◽  
Fumihiro Yoshimura ◽  
Hironori Kawada ◽  
Seiichiro Kanaya
Keyword(s):  
Esophageal Cancer ◽  
Cancer Surgery ◽  
Esophageal Cancer Surgery ◽  
Mesenteric Excision

Risk stratification of anastomotic leakage using eGFR and FIB-4 index in patients undergoing esophageal cancer surgery

2021 ◽  
Author(s):  
Keita Takahashi ◽  
Katsunori Nishikawa ◽  
Yuichiro Tanishima ◽  
Yoshitaka Ishikawa ◽  
Takahiro Masuda ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Risk Stratification ◽  
Anastomotic Leakage ◽  
Cancer Surgery ◽  
Esophageal Cancer Surgery

Volume and outcomes after esophageal cancer surgery: the experience of the Region of Lombardy—Italy

2013 ◽  
Vol 65 (4) ◽  
pp. 271-275 ◽  
Author(s):  
Uberto Fumagalli ◽  
Maurizio Bersani ◽  
Antonio Russo ◽  
Alessandra Melis ◽  
Stefano de Pascale ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Surgery ◽  
Esophageal Cancer Surgery

Esophageal Cancer Surgery in Heart Transplant Patients

2005 ◽  
Vol 80 (4) ◽  
pp. 1510-1512 ◽  
Author(s):  
Burkhard H.A. von Rahden ◽  
Hubert J. Stein ◽  
Georg Schmidt ◽  
Holger Bartels ◽  
Matthias Overbeck ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Heart Transplant ◽  
Cancer Surgery ◽  
Transplant Patients ◽  
Esophageal Cancer Surgery

Enteral immuno-enhanced diets with arginine are safe and beneficial for patients early after esophageal cancer surgery

2008 ◽  
Vol 21 (7) ◽  
pp. 619-627 ◽  
Author(s):  
Satoshi Aiko ◽  
Yutaka Yoshizumi ◽  
Takamitsu Ishizuka ◽  
Takuya Horio ◽  
Takashi Sakano ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Surgery ◽  
Esophageal Cancer Surgery

scholarly journals Textbook outcome for esophageal cancer surgery: an international consensus-based update of a quality measure

2021 ◽  
Author(s):  
Marianne C Kalff ◽  
Mark I van Berge Henegouwen ◽  
Suzanne S Gisbertz
Keyword(s):  
Esophageal Cancer ◽  
Cancer Surgery ◽  
Quality Measure ◽  
Resection Margins ◽  
International Consensus ◽  
Term Survival ◽  
Intraoperative Complication ◽  
Esophageal Cancer Surgery ◽  
Perioperative Course

Summary Textbook outcome for esophageal cancer surgery is a composite quality measure including 10 short-term surgical outcomes reflecting an uneventful perioperative course. Achieved textbook outcome is associated with improved long-term survival. This study aimed to update the original textbook outcome based on international consensus. Forty-five international expert esophageal cancer surgeons received a personal invitation to evaluate the 10 items in the original textbook outcome for esophageal cancer surgery and to rate 18 additional items divided over seven subcategories for their importance in the updated textbook outcome. Items were included in the updated textbook outcome if ≥80% of the respondents agreed on inclusion. In case multiple items within one subcategory reached ≥80% agreement, only the most inclusive item with the highest agreement rate was included. With a response rate of 80%, 36 expert esophageal cancer surgeons, from 34 hospitals, 16 countries, and 4 continents responded to this international survey. Based on the inclusion criteria, the updated quality indicator ‘textbook outcome for esophageal cancer surgery’ should consist of: tumor-negative resection margins, ≥20 lymph nodes retrieved and examined, no intraoperative complication, no complications Clavien–Dindo ≥III, no ICU/MCU readmission, no readmission related to the surgical procedure, no anastomotic leakage, no hospital stay ≥14 days, and no in-hospital mortality. This study resulted in an international consensus-based update of a quality measure, textbook outcome for esophageal cancer surgery. This updated textbook outcome should be implemented in quality assurance programs for centers performing esophageal cancer surgery, and could standardize quality measures used internationally.

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