Evidence map›Paper›PMID 37679581›Full record

ArticleSurgical endoscopy2023

Effect of thoracic cage width on surgery time and postoperative outcome in minimally invasive esophagectomy.

C Mann, T Jezycki, F Berlth, E Hadzijusufovic, E Uzun, A Mähringer-Kunz, H Lang, R Klöckner, P P Grimminger

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 24% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. 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

9 authors at 2 institutions in 1 country.

C MannDepartment of General-, Visceral- and Transplantation Surgery, University Medical Center Mainz, Mainz, Germany.
T JezyckiDepartment of Diagnostic and Interventional Radiology, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany.
F BerlthDepartment of General-, Visceral- and Transplantation Surgery, University Medical Center Mainz, Mainz, Germany.
E HadzijusufovicDepartment of General-, Visceral- and Transplantation Surgery, University Medical Center Mainz, Mainz, Germany.
E UzunDepartment of General-, Visceral- and Transplantation Surgery, University Medical Center Mainz, Mainz, Germany.
A Mähringer-KunzDepartment of Diagnostic and Interventional Radiology, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany.
H LangDepartment of General-, Visceral- and Transplantation Surgery, University Medical Center Mainz, Mainz, Germany.
R KlöcknerDepartment for Interventional Radiology, University Medical Center Lübeck, Lübeck, Germany.
P P GrimmingerDepartment of General-, Visceral- and Transplantation Surgery, University Medical Center Mainz, Mainz, Germany. peter.grimminger@unimedizin-mainz.de.ORCID 0000-0002-1859-9213
Johannes Gutenberg University Mainz · DEUniversity of Lübeck · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMinimally invasive esophagectomy (MIE) for esophageal cancer is a complex procedure that reduces postoperative morbidity in comparison to open approach. In this study, thoracic cage width as a factor to predict surgical difficulty in MIE was evaluated.

methodsAll patients of our institution receiving either total MIE or robotic-assisted MIE (RAMIE) with intrathoracic anastomosis between February 2016 and April 2021 for esophageal cancer were included in this study. Right unilateral thoracic cage width on the level of vena azygos crossing the esophagus was measured by the horizontal distance between the esophagus and parietal pleura on preoperative computer tomography. Patients' data as well as operative and postoperative details were collected in a prospective database. Correlation between thoracic cage width with duration of the thoracic procedure and postoperative complication rates was analyzed.

resultsOverall, 313 patients were eligible for this study. Thoracic width on vena azygos level ranged from 85 to 149 mm with a mean of 116.5 mm. In univariate analysis, a small thoracic width significantly correlated with longer duration of the thoracic procedure (p = 0.014). In multivariate analysis, small thoracic width and neoadjuvant therapy were identified as independent factors for long duration of the thoracic procedure (p = 0.006). Regarding postoperative complications, thoracic cage width was a significant risk factor for occurrence of postoperative pneumonia in the multivariate analysis (p = 0.045). Dividing the cohort into two groups of patients with narrow (≤ 107 mm, 19.5%) and wide thoraces (≥ 108 mm, 80.5%), the thoracic procedure was significantly prolonged by 17 min (204 min vs. 221 min, p = 0.014).

conclusionA small thoracic cage width is significantly correlated with longer operation time during thoracic phase of a MIE in Europe, which suggests increased surgical difficulty. Patients with small thoracic cage width may preferably be operated by MIE-experienced surgeons.

Indexed as

Esophageal NeoplasmsEsophagectomyHumansMinimally Invasive Surgical ProceduresPostoperative ComplicationsRetrospective StudiesRib CageRisk FactorsTreatment OutcomeEsophageal cancerMIEMinimally invasive esophagectomyRAMIESurgical difficultyThoracic cage width

Identifiers

PMID37679581
PMCPMC10615966
OpenAlexW4386498828

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.