Evidence map›Paper›PMID 38180542›Full record

ArticleSurgical endoscopy2024

Effects of endoluminal vacuum sponge therapy on the perfusion of gastric conduit in a porcine model for esophagectomy.

Eleni Amelia Felinska, Alexander Studier-Fischer, Berkin Özdemir, Estelle Willuth, Philipp Anthony Wise, Beat Müller-Stich, Felix Nickel

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

Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 18% 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

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

  1. Pooled it
  2. Review
  3. 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 at 2 institutions in 1 country.

Eleni Amelia FelinskaDepartment of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany.
Alexander Studier-FischerDepartment of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany.
Berkin ÖzdemirDepartment of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany.
Estelle WilluthDepartment of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany.
Philipp Anthony WiseDepartment of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany.
Beat Müller-StichDepartment of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany.
Felix NickelDepartment of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany. f.nickel@uke.de.ORCID 0000-0001-6066-8238
Heidelberg University · DEUniversität Hamburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAfter esophagectomy, the postoperative rate of anastomotic leakage is up to 30% and is the main driver of postoperative morbidity. Contemporary management includes endoluminal vacuum sponge therapy (EndoVAC) with good success rates. Vacuum therapy improves tissue perfusion in superficial wounds, but this has not been shown for gastric conduits. This study aimed to assess gastric conduit perfusion with EndoVAC in a porcine model for esophagectomy. MATERIAL AND

methodsA porcine model (n = 18) was used with gastric conduit formation and induction of ischemia at the cranial end of the gastric conduit with measurement of tissue perfusion over time. In three experimental groups EndoVAC therapy was then used in the gastric conduit (- 40, - 125, and - 200 mmHg). Changes in tissue perfusion and tissue edema were assessed using hyperspectral imaging. The study was approved by local authorities (Project License G-333/19, G-67/22).

resultsInduction of ischemia led to significant reduction of tissue oxygenation from 65.1 ± 2.5% to 44.7 ± 5.5% (p < 0.01). After EndoVAC therapy with - 125 mmHg a significant increase in tissue oxygenation to 61.9 ± 5.5% was seen after 60 min and stayed stable after 120 min (62.9 ± 9.4%, p < 0.01 vs tissue ischemia). A similar improvement was seen with EndoVAC therapy at - 200 mmHg. A nonsignificant increase in oxygenation levels was also seen after therapy with - 40 mmHg, from 46.3 ± 3.4% to 52.5 ± 4.3% and 53.9 ± 8.1% after 60 and 120 min respectively (p > 0.05). An increase in tissue edema was observed after 60 and 120 min of EndoVAC therapy with - 200 mmHg but not with - 40 and - 125 mmHg.

conclusionsEndoVAC therapy with a pressure of - 125 mmHg significantly increased tissue perfusion of ischemic gastric conduit. With better understanding of underlying physiology the optimal use of EndoVAC therapy can be determined including a possible preemptive use for gastric conduits with impaired arterial perfusion or venous congestion.

Indexed as

Esophageal NeoplasmsEsophagectomyAnastomosis, SurgicalAnastomotic LeakAnimalsEdemaIschemiaPerfusionStomachSwineAnastomotic leakEndoluminal vacuum therapyEsophagectomyGastric conduitHyperspectral imagingPerfusion

Identifiers

PMID38180542
PMCPMC10881612
OpenAlexW4390618583

What OpenQuestion holds

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LicenceCC BY
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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.