Evidence map›Paper›PMID 34596746›Full record

ArticleSurgical endoscopy2022

ERAS guidelines-driven upper gastrointestinal contrast study after esophagectomy.

Francesco Puccetti, Fredrik Klevebro, MadhanKumar Kuppusamy, Michal Hubka, Donald E Low

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 23% of its field
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

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. 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 at 2 institutions in 2 countries.

Francesco PuccettiDepartment of Thoracic Surgery and Thoracic Oncology, Virginia Mason Medical Center, 1100 Ninth Avenue, Seattle, WA, 98101, USA.
Fredrik KlevebroDivision of Surgery, Department of Clinical Science Intervention and Technology, Karolinska Institutet and Centre for Digestive Diseases, Karolinska University Hospital, Eugeniavägen 3Solna, 171 76, Stockholm, Sweden.
MadhanKumar KuppusamyDepartment of Thoracic Surgery and Thoracic Oncology, Virginia Mason Medical Center, 1100 Ninth Avenue, Seattle, WA, 98101, USA.
Michal HubkaDepartment of Thoracic Surgery and Thoracic Oncology, Virginia Mason Medical Center, 1100 Ninth Avenue, Seattle, WA, 98101, USA.
Donald E LowDepartment of Thoracic Surgery and Thoracic Oncology, Virginia Mason Medical Center, 1100 Ninth Avenue, Seattle, WA, 98101, USA. Donald.Low@virginiamason.org.ORCID http://orcid.org/0000-0002-3735-0958
Virginia Mason Medical Center · USKarolinska University Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly nasogastric tube (NGT) removal is a component of enhanced recovery after surgery (ERAS) protocol for esophagectomy. The aim of this study is to assess a protocol-driven application of UGI contrast study to facilitate early NGT removal and direct a standardized therapeutic response in patients with evidence for delayed gastric conduit emptying (DGCE).

methodsAll patients undergoing esophagectomy between January 2017 and October 2019 were prospectively enrolled. Esophageal resections were performed through different surgical approaches involving gastric conduit reconstruction. A standardized clinical protocol (SCP) was systematically applied, which targeted a UGI contrast study on POD 2-3 to allow immediate NGT removal or initiate DGCE protocols.

resultsThis study enrolled 50 patients undergoing open Ivor Lewis (42%), left thoracoabdominal (46%), and three-field procedure (12%) with gastric conduit reconstruction and either upper thoracic (66%) or cervical (34%) anastomosis. Jejunostomy was routinely placed while pyloric procedures were not performed. Patients achieving targeted contrast study (86%) demonstrated significantly earlier NGT removal (p-value 0.010), oral protocol initiation (0.001), and decreased length of hospital stay (6 vs 10 days, 0.024). Four patients (8%) presented with radiology signs of DCGE and underwent protocoled treatment, eventually achieving discharge similar to the overall study population (7 vs 8.5 days).

conclusionsProtocol-driven UGI contrast study can effectively provide objective data facilitating early NGT removal and discharge. Patients with DGCE can successfully undergo intervention to improve conduit emptying and adhere to ERAS discharge goals.

Indexed as

Enhanced Recovery After SurgeryEsophageal NeoplasmsAnastomosis, SurgicalEsophagectomyHumansPostoperative ComplicationsRetrospective StudiesDelayed Gastric emptyingERASEsophagectomyGastric conduit

Identifiers

PMID34596746
OpenAlexW3202408910

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.