Evidence map›Paper›PMID 39028419›Full record

ArticleGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2024

Importance of duodenal stump reinforcement to prevent stump leakage after gastrectomy: a large-scale multicenter retrospective study (KSCC DELICATE study).

Akihiko Sano, Yoshiro Imai, Takahisa Yamaguchi, Takeo Bamba, Naoki Shinno, Yoshiyuki Kawashima, Masanori Tokunaga, Yasuaki Enokida, Tomoya Tsukada, Satoru Hatakeyama and 20 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

6 citing papers in PubMed.

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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

30 authors.

Akihiko SanoDepartment of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan.
Yoshiro ImaiDepartment of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.
Takahisa YamaguchiDepartment of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
Takeo BambaDepartment of Gastroenterological Surgery, Niigata Cancer Center Hospital, Niigata, Japan.
Naoki ShinnoDepartment of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan.
Yoshiyuki KawashimaDepartment of Gastroenterological Surgery, Saitama Cancer Center, Ina-Machi, Japan.
Masanori TokunagaDepartment of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Yasuaki EnokidaDepartment of Gastroenterological Surgery, Gunma Prefectural Cancer Center, Ota, Japan.
Tomoya TsukadaDepartment of Surgery, Toyama Prefectural Central Hospital, Toyama, Japan.
Satoru HatakeyamaDepartment of Surgery, Niigata Prefectural Shibata Hospital, Shibata, Japan.
Tadashi KogaDepartment of Surgery, Iizuka Hospital, Iizuka, Japan.
Shirou KuwabaraDepartment of Digestive Surgery, Niigata City General Hospital, Niigata, Japan.
Naoki UrakawaDepartment of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Junichi AraiDepartment of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Manabu YamamotoDepartment of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
Itaru YasufukuDepartment of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of Medicine, Gifu, Japan.
Hironori IwasakiDepartment of Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan.
Masahiro SakonDepartment of Digestive Surgery, Nagano Municipal Hospital, Nagano, Japan.
Takuya HonbohDepartment of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan.
Yoshihiko KawaguchiFirst Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.
Tetsuya KusumotoDepartment of Gastroenterological Surgery, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Kazunori ShibaoDepartment of Surgery I, School of Medicine, University of Occupational and Environmental Health Japan, Kitakyushu, Japan.
Naoki HikiDepartment of Upper Gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
Nobuhiro NakazawaDepartment of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan.
Makoto SakaiDepartment of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan.
Makoto SohdaDepartment of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan.
Ken ShirabeDepartment of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan.
Eiji OkiDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Hideo BabaDepartment of Gastroenterological Surgery, Kumamoto University, Kumamoto, Japan.
Hiroshi SaekiDepartment of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan. h-saeki@gunma-u.ac.jp.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe significance of reinforcement of the duodenal stump with seromuscular sutures and the effectiveness of reinforced staplers in preventing duodenal stump leakage remain unclear. We aimed to explore the importance of duodenal stump reinforcement and determine the optimal reinforcement method for preventing duodenal stump leakage.

methodsThis retrospective cohort study was conducted between January 1, 2012 and December 31, 2021, with data analyzed between December 1, 2022 and September 30, 2023. This multicenter study across 57 institutes in Japan included 16,475 patients with gastric cancer who underwent radical gastrectomies. Elective open or minimally invasive (laparoscopic or robotic) gastrectomy was performed in patients with gastric cancer.

resultsDuodenal stump leakage occurred in 153 (0.93%) of 16,475 patients. The proportions of males, patients aged ≥ 75 years, and ≥ pN1 were higher in patients with duodenal stump leakage than in those without duodenal stump leakage. The incidence of duodenal stump leakage was significantly lower in the group treated with reinforcement by seromuscular sutures or using reinforced stapler than in the group without reinforcement (0.72% vs. 1.19%, p = 0.002). Duodenal stump leakage incidence was also significantly lower in high-volume institutions than in low-volume institutions (0.70% vs. 1.65%, p = 0.047). The rate of duodenal stump leakage-related mortality was 7.8% (12/153). In the multivariate analysis, preoperative asthma and duodenal invasion were identified as independent preoperative risk factors for duodenal stump leakage-related mortality.

conclusionsThe duodenal stump should be reinforced to prevent duodenal stump leakage after radical gastrectomy in patients with gastric cancer.

Indexed as

Anastomotic LeakGastrectomyStomach NeoplasmsAgedAged, 80 and overDuodenumFemaleHumansJapanLaparoscopyMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesSurgical StaplingDuodenal stump leakageDuodenal stump reinforcementGastric cancerReinforced staplerSeromuscular suture

Identifiers

PMID39028419

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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.