Evidence map›Paper›PMID 29344808›Full record

ArticleJournal of gastrointestinal cancer2019

Minimally Invasive Esophagectomy with Thoracic Duct Resection Post Neoadjuvant Chemoradiotherapy for Carcinoma Esophagus-Impact on Lymph Node Yield and Hemodynamic Parameters.

Santosh Anand, Raja Kalayarasan, Sandip Chandrasekar, Senthil Gnanasekaran, Biju Pottakkat

Abstract read
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In one paragraph

Article in Journal of gastrointestinal cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Review
  6. Minimal Invasive Esophagectomy-a New Dawn of EsophagealSurgery.Indian journal of surgical oncology · 2020
    Review
  7. Risk factors of chylothorax after esophagectomy.Journal of thoracic disease · 2019
    Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Santosh AnandDepartment of Surgical Gastroenterology, JIPMER, Room no 551, Fourth floor, Superspeciality block, Puducherry, 605006, India.
Raja KalayarasanDepartment of Surgical Gastroenterology, JIPMER, Room no 551, Fourth floor, Superspeciality block, Puducherry, 605006, India. kalayarasanraja@yahoo.com.
Sandip ChandrasekarDepartment of Surgical Gastroenterology, JIPMER, Room no 551, Fourth floor, Superspeciality block, Puducherry, 605006, India.
Senthil GnanasekaranDepartment of Surgical Gastroenterology, JIPMER, Room no 551, Fourth floor, Superspeciality block, Puducherry, 605006, India.
Biju PottakkatDepartment of Surgical Gastroenterology, JIPMER, Room no 551, Fourth floor, Superspeciality block, Puducherry, 605006, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeoadjuvant therapy followed by surgery is the current recommended treatment for locally advanced esophageal carcinoma. Thoracic duct (TD) resection was indicated for radical mediastinal lymphadenectomy. However, TD resection can cause hemodynamic disturbances. The presence of metastasis in TD has not been previously studied.

methodsTwenty-two patients who underwent minimally invasive esophagectomy with D2 lymphadenectomy after neoadjuvant chemoradiotherapy for esophageal squamous cell carcinoma were analyzed. Ten patients had their TD resected from thoracic inlet till the esophageal hiatus. Multiple histopathological sections of the TD were examined for evidence of tumor spread. Intraoperative and immediate (48 h) postoperative hemodynamic parameters, lymph node yield, and postoperative morbidity were compared between TD-resected and TD-preserved groups.

resultsThe median postoperative day 1 fluid requirement (3310 mL vs. 2875 mL, P = 0.059) and the median postoperative day 2 pulse rate were higher in the TD-resected group (111/min vs. 95/min, P = 0.043). There was no significant difference in the intraoperative fluid infusion, blood loss, urine output, mean blood pressure, pulse rate, postoperative urine output, and mean blood pressure between two groups. Median (range) mediastinal lymph node count was similar in TD-resected and TD-preserved groups [15(11-32) vs. 14(9-31), P = 0.283]. Pathological examination of TD did not reveal tumor cells in any of the patients. There was no significant difference in the postoperative morbidity between two groups except for cervical anastomotic dehiscence (P = 0.007).

conclusionsMinimally invasive esophagectomy with TD resection causes minor hemodynamic changes in the immediate postoperative period, without adversely affecting the postoperative outcome. In the setting of neoadjuvant chemoradiotherapy, TD resection does not increase lymph node yield.

Indexed as

Lymph Node ExcisionAdultAgedChemoradiotherapy, AdjuvantEsophageal NeoplasmsEsophageal Squamous Cell CarcinomaEsophagectomyFemaleHemodynamicsHumansLymphatic MetastasisLymph NodesMaleMiddle AgedNeoadjuvant TherapyPostoperative ComplicationsEsophageal cancerEsophagectomyLaparoscopyThoracic ductThoracoscopy

Identifiers

PMID29344808

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.