Evidence map›Paper›PMID 31385074›Full record

ArticleSurgical endoscopy2020

Evolving changes of minimally invasive esophagectomy: a single-institution experience.

Sahil Gambhir, Shaun Daly, Shelley Maithel, Luke R Putnam, James Nguyen, Brian R Smith, Ninh T Nguyen

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Review
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.

Sahil GambhirDepartment of Surgery, University of California Irvine Medical Center, Orange, CA, USA.
Shaun DalyDepartment of Surgery, University of California Irvine Medical Center, Orange, CA, USA.
Shelley MaithelDepartment of Surgery, University of California Irvine Medical Center, Orange, CA, USA.
Luke R PutnamDepartment of Surgery, University of California Irvine Medical Center, Orange, CA, USA.
James NguyenDepartment of Surgery, University of California Irvine Medical Center, Orange, CA, USA.
Brian R SmithDepartment of Surgery, University of California Irvine Medical Center, Orange, CA, USA.
Ninh T NguyenDepartment of Surgery, University of California Irvine Medical Center, Orange, CA, USA. ninhn@uci.edu.ORCID 0000-0003-3745-966X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInitial adoption of minimally invasive esophagectomy (MIE) began in the late 1990s but its surgical technique, perioperative management, and outcome continues to evolve.

methodsThe aim of this study was to examine the evolving changes in the technique, outcome, and new strategies in management of postoperative leaks after MIE was performed at a single institution over a two-decade period. A retrospective chart review of 75 MIE operations was performed between November 2011 and September 2018 and this was compared to the initial series of 104 MIE operations performed by the same group between 1998 and 2007. Operative technique, outcomes, and management strategies of leaks were compared.

resultsThere were 65 males (86.7%) with an average age of 61 years. The laparoscopic/thoracoscopic Ivor Lewis esophagectomy became the preferred MIE approach (49% of cases in the initial vs. 95% in the current series). Compared to the initial case series, there was no significant difference in median length of stay (8 vs. 8 days), major complications (12.5% vs. 14.7%, p = 0.68), incidence of leak (9.6% vs. 10.6%, p = 0.82), anastomotic stricture (26% vs. 32.0%, p = 0.38), or in-hospital mortality (2.9% vs. 2.6%, p = 0.47). Management of esophageal leaks has changed from primarily thoracotomy ± diversion initially (50% of leak cases) to endoscopic stenting ± laparoscopy/thoracoscopy currently (87.5% of leak cases).

conclusionIn a single-institutional series of MIE over two decades, there was a shift toward a preference for the laparoscopic/thoracoscopic Ivor Lewis approach with similar outcomes. The management of postoperative leaks drastically changed with predilection toward minimally invasive option with endoscopic drainage and stenting.

Indexed as

AdultAgedAnastomotic LeakEsophageal DiseasesEsophagectomyFemaleHospital MortalityHumansLaparoscopyLength of StayMaleMiddle AgedMinimally Invasive Surgical ProceduresRetrospective StudiesThoracoscopyTreatment OutcomeEsophageal stentIvor LewisMinimally invasive esophagectomy

Identifiers

PMID31385074

What OpenQuestion holds

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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.