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Article ; Online: Clinical significance of sarcopenic dysphagia for patients with esophageal cancer undergoing esophagectomy: A review.

Oguma, Junya / Ozawa, Soji / Ishiyama, Koshiro / Daiko, Hiroyuki

Annals of gastroenterological surgery

2022 Volume 6, Issue 6, Page(s) 738–745

Abstract: The relationships among esophagectomy for esophageal cancer, dysphagia, and sarcopenia are still unclear. We considered appropriate interventions for patients with resectable esophageal cancer for the purpose of reducing postoperative dysphagia and ... ...

Abstract	The relationships among esophagectomy for esophageal cancer, dysphagia, and sarcopenia are still unclear. We considered appropriate interventions for patients with resectable esophageal cancer for the purpose of reducing postoperative dysphagia and aspiration pneumonia. Dysphagia in patients with esophageal cancer is caused by patient characteristics, such as pathophysiology and age, or complications after esophagectomy. Recently, sarcopenic dysphagia, defined as dysphagia associated with whole-body sarcopenia, has attracted attention in various fields, and a large proportion of patients with esophageal cancer are expected to have sarcopenic dysphagia. Our systematic review and meta-analysis suggested that preoperative sarcopenia in patients with esophageal cancer is related to pulmonary complications after esophagectomy, and some reports also suggested that sarcopenia in swallowing-related muscles, such as the geniohyoid muscle and tongue, might be associated with postoperative pneumonia or dysphagia after esophagectomy. However, clinical studies on sarcopenic dysphagia in patients with esophageal cancer have been limited. To prevent sarcopenic dysphagia after esophagectomy, perioperative interventions involving not only swallowing rehabilitation, but also physical exercise and nutritional support are important. Moreover, several reports have suggested that the chin-down maneuver might be effective for preventing aspiration after an esophagectomy. To inhibit the progression of sarcopenic dysphagia after esophagectomy, evaluations and interventions by multidisciplinary staff are likely to be necessary.
Language	English
Publishing date	2022-07-28
Publishing country	Japan
Document type	Journal Article ; Review
ISSN	2475-0328
ISSN (online)	2475-0328
DOI	10.1002/ags3.12603
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Article ; Online: Does Preoperative Corticosteroid Administration Improve the Short-Term Outcome of Minimally Invasive Esophagectomy for Esophageal Cancer? A Propensity Score-Matched Analysis.

Ishiyama, Koshiro / Oguma, Junya / Kubo, Kentaro / Kanematsu, Kyohei / Fujii, Yusuke / Kurita, Daisuke / Daiko, Hiroyuki

Annals of surgical oncology

2022 Volume 29, Issue 11, Page(s) 6886–6893

Abstract: Background: In open esophagectomy for esophageal cancer, steroid administration is associated with attenuated postoperative inflammation and reduced complications. However, the efficacy of steroids in minimally invasive esophagectomy (MIE) is uncertain. ...

Abstract	Background: In open esophagectomy for esophageal cancer, steroid administration is associated with attenuated postoperative inflammation and reduced complications. However, the efficacy of steroids in minimally invasive esophagectomy (MIE) is uncertain. This study aimed to investigate the impact of steroid administration on short-term postoperative outcomes in MIE. Methods: The study compared 458 patients who underwent MIE between April 2017 and December 2021. The patients were divided into steroid (n = 206) and non-steroid (n = 252) groups, and 160 paired cases were compared by 1:1 propensity score-matching. Results: In the steroid group versus the non-steroid group, the intensive care unit stay was significantly shorter (2.6 vs 3.3 days; P = 0.001), and the incidence of surgical-site infection (SSI) was significantly lower (1.2 % vs 13.1 %; P < 0.001). The incidence of pneumonia tended to be lower in the steroid group, but not significantly lower (19.3 % vs 29.3 %; P = 0.065). Multivariate analysis showed that steroid administration independently affected SSI (odds ratio, 11.6; 95 % confidence interval, 3.3-73.6; P < 0.001). Compared with the non-steroid group, the steroid group had more favorable arterial partial pressure of oxygen/fraction of inspired oxygen ratio (503 ± 178 vs 380 ± 104; P < 0.001) and body temperature (37.2 ± 0.54 °C vs 38.3 ± 0.66 °C; P < 0.001) on postoperative day (POD) 0, heart rate (beats per minute) (74.6 ± 8.9 vs 84 ± 11.4; P < 0.001) on POD 1, and C-reactive protein concentration (7.07 ± 3.4 vs 13.7 ± 6.4 mg/dL; P < 0.001) on POD 3. Conclusions: In MIE, steroid administration was associated with reduced SSI, suggesting an attenuated inflammatory response to surgical stress.
MeSH term(s)	Adrenal Cortex Hormones ; C-Reactive Protein ; Esophageal Neoplasms/surgery ; Esophagectomy/adverse effects ; Humans ; Oxygen ; Propensity Score ; Retrospective Studies ; Treatment Outcome
Chemical Substances	Adrenal Cortex Hormones ; C-Reactive Protein (9007-41-4) ; Oxygen (S88TT14065)
Language	English
Publishing date	2022-06-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-022-11821-9
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Article ; Online: Perioperative Decrease in Tongue Pressure is an Intervenable Predictor of Aspiration After Esophagectomy.

Kojima, Kazuhiro / Fukushima, Takuya / Kurita, Daisuke / Matsuoka, Aiko / Ishiyama, Koshiro / Oguma, Junya / Daiko, Hiroyuki

Dysphagia

2022 Volume 38, Issue 4, Page(s) 1147–1155

Abstract: Despite the increasing use of minimally invasive esophagectomies, aspiration pneumonia remains the most serious complication. This study clarified the association between perioperative tongue pressure and postoperative aspiration after thoracoscopic- ... ...

Abstract	Despite the increasing use of minimally invasive esophagectomies, aspiration pneumonia remains the most serious complication. This study clarified the association between perioperative tongue pressure and postoperative aspiration after thoracoscopic-laparoscopic esophagectomy in patients with esophageal cancer. This retrospective, single-center, observational study evaluated data of 216 patients scheduled for thoracoscopic-laparoscopic esophagectomy. Tongue pressure was measured before the procedure and on postoperative day 6; perioperative changes were assessed. Patients were divided into non-aspiration and aspiration groups according to penetration-aspiration scale scores. Hierarchical and stratified logistic regression analyses were performed to identify factors associated with aspiration. Receiver operating characteristic curves were used to assess the cut-off value of perioperative changes in tongue pressure for aspiration. Perioperative changes in tongue pressure (odds ratio 0.92; 95% confidence interval 0.88-0.96, P < 0.001), age (odds ratio 1.07; 95% confidence interval 1.01-1.13, P = 0.013), and postoperative recurrent laryngeal nerve palsy (odds ratio 3.04; 95% confidence interval 1.15-8.03, P = 0.025) were significantly associated with aspiration. The cut-off value of perioperative changes in tongue pressure for postoperative aspiration was - 6.58%. In addition, decreases in tongue pressure were associated with aspiration regardless of recurrent laryngeal nerve palsy and age. The perioperative decrease in tongue pressure, higher age, and postoperative recurrent laryngeal nerve palsy were significant factors strongly associated with aspiration in the acute phase post-esophagectomy. Decreased tongue pressure is the only intervenable predictor of aspiration. Rehabilitation for preventing decreases in tongue pressure may reduce the risk of aspiration.
MeSH term(s)	Humans ; Retrospective Studies ; Esophagectomy/adverse effects ; Esophagectomy/methods ; Vocal Cord Paralysis/complications ; Pressure ; Tongue ; Esophageal Neoplasms/surgery ; Esophageal Neoplasms/complications ; Postoperative Complications/etiology
Language	English
Publishing date	2022-12-01
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	632764-3
ISSN	1432-0460 ; 0179-051X
ISSN (online)	1432-0460
ISSN	0179-051X
DOI	10.1007/s00455-022-10541-2
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Zs.A 2130: Show issues

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Article ; Online: Non-curative resection for surgical T4b esophageal cancer: esophagectomy or non-esophagectomy?

Fujii, Yusuke / Daiko, Hiroyuki / Kubo, Kentaro / Kanematsu, Kyohei / Utsunomiya, Daichi / Kurita, Daisuke / Ishiyama, Koshiro / Oguma, Junya

Langenbeck's archives of surgery

2023 Volume 408, Issue 1, Page(s) 201

Abstract: Background: Recently, with the development of multidisciplinary treatment, the treatment outcomes of esophageal cancer (EC) have improved. However, despite advances in diagnostic imaging modalities, preoperative diagnosis of T4 EC is still difficult, ... ...

Abstract	Background: Recently, with the development of multidisciplinary treatment, the treatment outcomes of esophageal cancer (EC) have improved. However, despite advances in diagnostic imaging modalities, preoperative diagnosis of T4 EC is still difficult, and the prognosis of T4 EC remains very poor. In addition, the prognosis of surgical T4b EC (sT4b EC) after surgery remains unclear. In this study, we retrospectively reviewed sT4b EC. Methods: We evaluated the clinical course of sT4b EC and compared palliative esophagectomy with R2 resection (PE group) with other procedures without esophagectomy (NE group) (e.g., only esophagostomy) for sT4b EC. Results: Forty-seven patients with thoracic EC underwent R2 resection at our institution between January 2009 and December 2020. Thirty-four patients were in the PE group, and 13 patients were in the NE group. The 2-year overall survival rate was 0% in the PE group and 20.2% in the NE group (p = 0.882). There was one case of long-term survival in the NE group that underwent surgery followed by definitive chemoradiation. Postoperative complications (Clavien-Dindo grade ≥ 3) were observed in 25 patients (73.5%) in the PE group and in three patients (23.1%) in the NE group (p = 0.031). The median time to the initiation of postoperative treatment was 68.1 days in the PE group and 18.6 days in the NE group (p = 0191). Conclusions: If EC is diagnosed as sT4b, palliative esophagectomy should be avoided because of the high complication rate and the lack of long-term survival.
MeSH term(s)	Humans ; Retrospective Studies ; Esophageal Neoplasms/surgery ; Treatment Outcome ; Prognosis ; Carcinoma, Squamous Cell/surgery
Language	English
Publishing date	2023-05-20
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-023-02940-2
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Uk I Zs.10: Show issues

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Article ; Online: Preoperative physical activity is associated with prognosis in patients with esophageal cancer undergoing thoracoscopic-laparoscopic esophagectomy after neoadjuvant chemotherapy.

Fukushima, Takuya / Watanabe, Noriko / Okita, Yusuke / Yokota, Shota / Kurita, Daisuke / Ishiyama, Koshiro / Oguma, Junya / Kawai, Akira / Daiko, Hiroyuki

General thoracic and cardiovascular surgery

2023 Volume 72, Issue 2, Page(s) 134–143

Abstract: Objective: This study examined the association between a single preoperative physiotherapy session during neoadjuvant chemotherapy and physical function and that between preoperative physical activity and prognosis.: Methods: In this retrospective, ... ...

Abstract	Objective: This study examined the association between a single preoperative physiotherapy session during neoadjuvant chemotherapy and physical function and that between preoperative physical activity and prognosis. Methods: In this retrospective, single-center, observational study, we evaluated data from 234 patients scheduled for neoadjuvant chemotherapy and thoracoscopic-laparoscopic esophagectomy who underwent a single preoperative physiotherapy session. The five-repetition sit-to-stand test was performed before and after neoadjuvant chemotherapy. After neoadjuvant chemotherapy, patients were classified into high- and low-physical activity groups based on preoperative physical activity. To examine the association between preoperative physiotherapy and changes in physical function, a multivariate regression analysis was performed. The Cox proportional hazards model was used to investigate the association between preoperative physical activity and overall survival. Results: The median percentage change in the five-repetition sit-to-stand test score was - 3.36%. In the multivariate regression analysis, the regression coefficient of the constant term was - 23.93 (95% confidence interval - 45.31 to - 2.56; P = 0.028). Low physical activity was significantly associated with overall survival after adjustment for confounding factors (P = 0.040). Conclusions: This study demonstrated that a single preoperative physiotherapy session during neoadjuvant chemotherapy improves physical function, and preoperative physical activity is significantly associated with prognosis.
MeSH term(s)	Humans ; Esophagectomy/adverse effects ; Retrospective Studies ; Neoadjuvant Therapy ; Esophageal Neoplasms/surgery ; Esophageal Neoplasms/drug therapy ; Prognosis
Language	English
Publishing date	2023-09-27
Publishing country	Japan
Document type	Observational Study ; Journal Article
ZDB-ID	2376888-5
ISSN	1863-6713 ; 1863-6705
ISSN (online)	1863-6713
ISSN	1863-6705
DOI	10.1007/s11748-023-01977-w
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Zs.A 1173: Show issues

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Article ; Online: Preoperative docetaxel, cisplatin, and 5-fluorouracil for resectable locally advanced esophageal and esophagogastric junctional adenocarcinoma.

Hirose, Toshiharu / Yamamoto, Shun / Honma, Yoshitaka / Yokoyama, Kazuki / Hirano, Hidekazu / Okita, Natsuko / Shoji, Hirokazu / Iwasa, Satoru / Takashima, Atsuo / Ishiyama, Koshiro / Oguma, Junya / Daiko, Hiroyuki / Maeda, Shin / Kato, Ken

Esophagus : official journal of the Japan Esophageal Society

2024

Abstract: Background: Chemotherapy consisting of 5-fluorouracil, leucovorin, oxaliplatin, and docetaxel is the standard perioperative treatment for resectable esophageal adenocarcinoma and esophagogastric junctional adenocarcinoma (EGJ-AC) in Western countries. ... ...

Abstract	Background: Chemotherapy consisting of 5-fluorouracil, leucovorin, oxaliplatin, and docetaxel is the standard perioperative treatment for resectable esophageal adenocarcinoma and esophagogastric junctional adenocarcinoma (EGJ-AC) in Western countries. Meanwhile, preoperative chemotherapy consisting of docetaxel, cisplatin, and 5-fluorouracil (DCF) has been developed for esophageal squamous cell carcinoma in Japan. However, there are few reports on the safety and efficacy of preoperative DCF for resectable EGJ-AC in the Japanese population. Methods: Patients with histologically confirmed resectable EGJ-AC who received preoperative DCF (docetaxel 70 mg/m Results: Thirty-two patients were included. Median follow-up was 28.7 (range, 5.2-70.8) months and median age was 63 (range, 42-80) years. Twenty-one patients (66%) had a performance status of 0. The proportions of clinical stage IIA/IIB/III/IVA/IVB disease were 3%/0%/44%/44%/9%, respectively. The treatment completion rate was 84%. A histopathological response of grade 1a/1b/2/3 was obtained in 58%/26%/13%/3% of cases. Median PFS was 40.7 months (95% confidence interval 11.8-NA). Median OS was not reached (80.8% at 3 years). Grade ≥ 3 adverse events were observed in 63% of cases (neutropenia, 44%; febrile neutropenia, 13%). No treatment-related deaths occurred. Conclusions: Preoperative DCF for resectable EGJ-AC was well tolerated and has promising efficacy.
Language	English
Publishing date	2024-03-12
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2133367-1
ISSN	1612-9067 ; 1612-9059
ISSN (online)	1612-9067
ISSN	1612-9059
DOI	10.1007/s10388-024-01050-2
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Article ; Online: Technical feasibility and oncological outcomes of robotic esophagectomy compared with conventional thoracoscopic esophagectomy for clinical T3 or T4 locally advanced esophageal cancer: a propensity-matched analysis.

Daiko, Hiroyuki / Oguma, Junya / Ishiyama, Koshiro / Kurita, Daisuke / Kubo, Kentaro / Kubo, Yuto / Utsunomiya, Daichi / Igaue, Shota / Nozaki, Ryoko / Leng, Xue-Feng / Fujita, Takeo / Fujiwara, Hisashi

Surgical endoscopy

2024

Abstract: Background: Minimally invasive esophagectomy is the first-line approach for esophageal cancer; however, there has recently been a paradigm shift toward robotic esophagectomy (RE). We investigated the clinical outcomes of patients who underwent RE ... ...

Abstract	Background: Minimally invasive esophagectomy is the first-line approach for esophageal cancer; however, there has recently been a paradigm shift toward robotic esophagectomy (RE). We investigated the clinical outcomes of patients who underwent RE compared with those of patients who underwent conventional minimally invasive thoracoscopic esophagectomy (TE) for locally advanced cT3 or cT4 esophageal cancer using a propensity-matched analysis. Methods: Overall, 342 patients with locally advanced cT3 or cT4 esophageal cancer underwent transthoracic esophagectomy with total mediastinal lymph node dissection between 2018 and 2022. The propensity-matched analysis was performed to assign the patients to either RE or TE by covariates of histological type, tumor location, and clinical N factor. Results: Overall, 87 patients were recruited in each of the RE and TE groups according to the propensity-matched analysis. The total complication rate and the rates of the three major complications (recurrent laryngeal nerve paralysis, anastomotic leakage, and pneumonia) were not significantly different between the RE and TE groups. However, the peak C-reactive protein concentration on postoperative day 3, rate of surgical site infection, and intensive care unit length of stay after surgery were significantly shorter in the RE group than in the TE group. No significant differences were observed in the harvested total and mediastinal lymph nodes. The total operation time was significantly longer in the RE group, while the thoracic operation time was shorter in the RE group than in the TE group. There was no significant difference between the two groups in the recurrence rate of oncological outcomes after surgery. Conclusion: RE may facilitate early recovery after esophagectomy with total mediastinal lymph node dissection and has the same technical feasibility and oncological outcomes as TE.
Language	English
Publishing date	2024-05-16
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-024-10872-1
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Article ; Online: Neoadjuvant Chemotherapy Improves Feasibility of Larynx Preservation and Prognosis in Resectable Locally Advanced Cervical Esophageal Cancer.

Kubo, Yuto / Nozaki, Ryoko / Igaue, Shota / Utsunomiya, Daichi / Kubo, Kentaro / Yamamoto, Shun / Kurita, Daisuke / Kashihara, Tairo / Ishiyama, Koshiro / Honma, Yoshitaka / Oguma, Junya / Kato, Ken / Daiko, Hiroyuki

Annals of surgical oncology

2024

Abstract: Background: The optimal strategy for cervical advanced esophageal cancer remains controversial in terms of oncologic outcome as well as vocal and swallowing function. Recently, in East Asian countries, neoadjuvant chemotherapy (NAC) has been a standard ... ...

Abstract	Background: The optimal strategy for cervical advanced esophageal cancer remains controversial in terms of oncologic outcome as well as vocal and swallowing function. Recently, in East Asian countries, neoadjuvant chemotherapy (NAC) has been a standard strategy for advanced esophageal cancer. Methods: This study included 37 patients who underwent NAC, and 33 patients who underwent definitive chemoradiation therapy (dCRT) as larynx-preserving treatment for locally advanced cervical esophageal cancer from 2016 to 2021. This study retrospectively investigated outcomes, with comparison between NAC and dCRT for locally advanced cervical esophageal cancer. Results: Larynx preservation was successful for all the patients with NAC and dCRT. After NAC, the rate of complete or partial response was 78.4%, and 30 patients underwent larynx-preserving surgery. On the other hand, after dCRT, the complete response rate was 71.9%, and 4 patients underwent larynx-preserving salvage surgery. Overall survival (OS) and progression free survival were similar between the two groups. However, for the patients with resectable cervical esophageal cancer (cT1/2/3), the 2-year OS rate was significantly higher with NAC (79.9%) than with dCRT (56.8%) (P = 0.022), and the multivariate analyses identified only NAC and cN0, one of the two as a significantly independent factor associated with a better OS (NAC: P = 0.041; cN0, 1: P = 0.036). Conclusion: The study showed that NAC as larynx-preserving surgery for resectable cervical esophageal cancer preserved function and had a better prognosis than dCRT. The authors suggest that NAC may be standard strategy for larynx preservation in patients with resectable cervical esophageal cancer.
Language	English
Publishing date	2024-05-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-024-15432-4
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Article ; Online: Feasibility of conversion thoracoscopic esophagectomy after induction therapy for locally advanced unresectable esophageal squamous cell carcinoma.

Kubo, Kentaro / Kanematsu, Kyohei / Kurita, Daisuke / Ishiyama, Koshiro / Oguma, Junya / Itami, Jun / Daiko, Hiroyuki

Japanese journal of clinical oncology

2021 Volume 51, Issue 8, Page(s) 1225–1231

Abstract: Background: Recently, patients with cT4b esophageal cancer often require conversion surgery following induction therapy, for which the standard procedure is open esophagectomy. However, thoracoscopic esophagectomy, including thoracoscopic esophagectomy ... ...

Abstract	Background: Recently, patients with cT4b esophageal cancer often require conversion surgery following induction therapy, for which the standard procedure is open esophagectomy. However, thoracoscopic esophagectomy, including thoracoscopic esophagectomy in the prone position, is increasingly used. We compared short-term outcomes of thoracoscopic esophagectomy and open esophagectomy in this setting. Methods: We retrospectively analyzed 14 patients who underwent thoracoscopic esophagectomy, and 10 who underwent open esophagectomy, for locally advanced unresectable esophageal cancer after induction therapy between March 2007 and July 2020. Results: The two groups did not significantly differ in patient background. Median total and thoracic surgical times were both significantly longer for open esophagectomy than for thoracoscopic esophagectomy. Median blood loss was also greater in the open esophagectomy group than in the thoracoscopic esophagectomy group. The thoracoscopic esophagectomy group also had significantly shorter median chest drain duration; and lower C-reactive protein levels on the second and third postoperative days. The two groups did not significantly differ in total complications or postoperative hospital stay. Conclusions: Thoracoscopic esophagectomy is as safe and feasible as open esophagectomy for conversion surgery after induction therapy for locally advanced unresectable esophageal squamous cell carcinoma.
MeSH term(s)	Esophageal Neoplasms/diagnostic imaging ; Esophageal Neoplasms/drug therapy ; Esophageal Neoplasms/surgery ; Esophageal Squamous Cell Carcinoma/diagnostic imaging ; Esophageal Squamous Cell Carcinoma/drug therapy ; Esophageal Squamous Cell Carcinoma/surgery ; Esophagectomy/methods ; Feasibility Studies ; Humans ; Induction Chemotherapy ; Lymph Node Excision ; Postoperative Complications ; Retrospective Studies ; Thoracoscopy
Language	English
Publishing date	2021-06-10
Publishing country	England
Document type	Journal Article
ZDB-ID	190978-2
ISSN	1465-3621 ; 0368-2811
ISSN (online)	1465-3621
ISSN	0368-2811
DOI	10.1093/jjco/hyab085
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Zs.A 1298: Show issues

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Article ; Online: Salvage minimally invasive esophagectomy after definitive chemoradiotherapy for esophageal cancer can improve postoperative complications compared with salvage open esophagectomy.

Ishiyama, Koshiro / Oguma, Junya / Kubo, Kentaro / Kanematsu, Kyohei / Kurita, Daisuke / Daiko, Hiroyuki

Surgical endoscopy

2021 Volume 36, Issue 5, Page(s) 3504–3510

Abstract: Background: Although the advantage of minimally invasive esophagectomy (MIE) over open esophagectomy (OE) in planned esophagectomy is being established, the utility of salvage MIE (S-MIE) remains unclear. We aimed to investigate the feasibility and ... ...

Abstract	Background: Although the advantage of minimally invasive esophagectomy (MIE) over open esophagectomy (OE) in planned esophagectomy is being established, the utility of salvage MIE (S-MIE) remains unclear. We aimed to investigate the feasibility and advantage of S-MIE compared with salvage OE (S-OE). Methods: We retrospectively assessed 82 patients who underwent salvage esophagectomy after definitive chemoradiotherapy for thoracic esophageal cancer between January 2007 and April 2020. Perioperative factors and postoperative complications were compared between the S-OE group (n = 62) and the S-MIE group (n = 20). Logistic regression analysis was performed to analyze the factors associated with postoperative complications. Results: Regarding the patients' preoperative characteristics, the S-OE group had a significant number of grade ≥ cT3 patients vs the S-MIE group (69% vs 35%, respectively; p = 0.006), whereas ycT rates were comparable. Compared with S-OE, S-MIE had comparable operative time, number of harvested thoracic lymph nodes, and R0 resection, but significantly less estimated blood loss (150 ml and 395 ml, respectively; p = 0.003). Regarding postoperative complications, total complications (79% vs 50%; p = 0.01) and pneumonia (48.3% vs 20%; p = 0.02) rates were significantly lower with S-OE vs S-MIE, respectively. On multivariate analysis, S-MIE was an independent factor associated with postoperative pneumonia (odds ratio: 0.29, 95% confidence interval: 0.06-0.99; p = 0.04) and total complications (odds ratio: 0.26, 95% confidence interval: 0.07-0.86; p = 0.02). Conclusion: S-MIE was feasible for salvage esophagectomy, with favorable short-term outcomes vs S-OE regarding postoperative pneumonia and total complications.
MeSH term(s)	Chemoradiotherapy/adverse effects ; Esophageal Neoplasms/complications ; Esophageal Neoplasms/surgery ; Esophagectomy/adverse effects ; Humans ; Minimally Invasive Surgical Procedures/adverse effects ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2021-10-12
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-021-08672-y
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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Cologne/Königswinter

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Full text online

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Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito