Evidence map›Paper›PMID 29845573›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2018

Gastric Ischemic Conditioning Prior to Esophagectomy Is Associated with Decreased Stricture Rate and Overall Anastomotic Complications.

Steve R Siegal, Abhishek D Parmar, Kelly R Haisley, Brandon H Tieu, Paul H Schipper, John G Hunter, James P Dolan

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–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

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Review
  7. 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

7 authors.

Steve R SiegalDepartment of Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park RD, Mail Code: L223A, Portland, OR, 97239, USA.
Abhishek D ParmarDepartment of Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park RD, Mail Code: L223A, Portland, OR, 97239, USA.
Kelly R HaisleyDepartment of Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park RD, Mail Code: L223A, Portland, OR, 97239, USA.
Brandon H TieuDepartment of Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park RD, Mail Code: L223A, Portland, OR, 97239, USA.
Paul H SchipperDepartment of Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park RD, Mail Code: L223A, Portland, OR, 97239, USA.
John G HunterDepartment of Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park RD, Mail Code: L223A, Portland, OR, 97239, USA.
James P DolanDepartment of Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park RD, Mail Code: L223A, Portland, OR, 97239, USA. dolanj@ohsu.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGastric ischemic conditioning prior to esophagectomy can increase neovascularization of the new conduit. Prior studies of ischemic conditioning have only investigated reductions in anastomotic leaks. Our aim was to analyze the association between gastric conditioning and all anastomotic outcomes as well as overall morbidity in our cohort of esophagectomy patients.

methodsWe performed a retrospective review of patients undergoing esophagectomy from 2010 to 2015 in a National Cancer Institute designated center. Ischemic conditioning (IC) was performed on morbidly obese patients, those with cardiovascular disease or uncontrolled diabetes, and those requiring feeding jejunostomy and active tobacco users. IC consisted of transection of the short gastric vessels and ligation of the left gastric vessels. Primary outcomes consisted of all postoperative anastomotic complications. Secondary outcomes were overall morbidity.

resultsTwo-hundred and seven esophagectomies were performed with an average follow-up of 19 months. Thirty-eight patients (18.4%) underwent conditioning (IC). This group was similar to patients not conditioned (NIC) in age, preoperative pathology, and surgical approach. Five patients in the ischemic conditioning group (13.2%) and 57 patients (33.7%) in the NIC experienced anastomotic complications (p = 0.011). Ischemic conditioning significantly reduced the postoperative stricture rate fourfold (5.3 vs. 20.7% p = 0.02). IC patients experienced significantly fewer complications overall (36.8 vs. 56.2% p = 0.03).

conclusionsGastric ischemic conditioning is associated with fewer overall anastomotic complications, fewer strictures, and less morbidity. Randomized studies may determine optimal selection criteria to determine whom best benefits from ischemic conditioning.

Indexed as

Ischemic PreconditioningAdultAgedAged, 80 and overAnastomosis, SurgicalAnastomotic LeakConstriction, PathologicEsophagectomyEsophagusFemaleHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesStomachAnastomotic complicationEsophageal cancerEsophagectomyIschemic conditioning

Identifiers

PMID29845573

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.