Evidence map›Paper›PMID 40342097›Full record

ArticleSurgical endoscopy2025

Vascularity of the gastric conduit predicts complications after Ivor-Lewis esophagectomy.

Julian Lemties, Carolin Scheidt, Jin-On Jung, Naita M Wirsik, Leandra Lukomski, Dolores Krauss, Anders Grabenkamp, Alexander R Stier, Su Ir Lyu, Alexander I Damanakis and 7 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

5 citing papers in PubMed.

  1. Article
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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

17 authors.

Julian Lemties *Department of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany. julian.lemties@uk-koeln.de.
Carolin Scheidt *Department of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Jin-On JungDepartment of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Naita M WirsikDepartment of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Leandra LukomskiDepartment of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Dolores KraussDepartment of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Anders GrabenkampDepartment of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Alexander R StierDepartment of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Su Ir LyuInstitute of Pathology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
Alexander I DamanakisDepartment of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Benjamin BabicDepartment of General and Visceral Surgery, Sana Klinikum Offenbach, Offenbach am Main, Germany.
Alexander QuaasInstitute of Pathology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
Thomas SchmidtDepartment of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Hans F FuchsDepartment of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Christiane J BrunsDepartment of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Wolfgang SchröderDepartment of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Lars M SchiffmannDepartment of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.

Funding

Medizinische Fakultät, Universität zu Köln Köln Fortune Program (140/2023)
6 · The paper itself

Abstract

backgroundAnastomotic leakage (AL) contributes to postoperative morbidity and mortality after Ivor-Lewis esophagectomy. Vascular high-risk patients show a significantly increased risk of AL. We previously showed that laparoscopic ischemic conditioning (ISCON) of the stomach prior esophagectomy in these high-risk patients is a safe procedure that induces neoangiogenesis at the anastomotic site. Our data also suggested that this directly impacts on anastomotic healing. To further investigate the hypothesis that gastric conduit vascularization directly influences postoperative morbidity, we evaluated gastric conduit vascularity in a cohort of patients undergoing two-stage esophagectomy prior to the ISCON era. MATERIAL AND

methodsSeventy-nine patients who underwent two-stage esophagectomy from 2016 to 2021 at our center were retrospectively analyzed from a prospectively maintained database. Microvessel density (MVD) of the gastric conduit at the anastomotic region was evaluated by CD34 staining of the gastric stapler ring. Analysis of microvessel density (MVD) was performed using ImageJ. Patients were stratified into low- and high-MVD groups, and MVD was correlated with clinical outcomes.

resultsPatients with a high MVD showed a significantly lower rate of anastomotic leakage (AL) in comparison to patients with low MVD (6.25% vs. 22.58% p=0.043). Furthermore, a high MVD was associated with a lower rate of major complications (Clavien Dindo ≥ IIIb) (12.50% vs. 38.71% p=0.012) and a shorter hospital stay (17.9 days vs. 23.1 days, p=0.045).

conclusionVascularization of the stomach might function as surgical biomarker of AL in patients undergoing two-stage esophagectomy. Prospective trials have to further substantiate this finding.

Indexed as

Anastomotic LeakEsophageal NeoplasmsEsophagectomyIschemic PreconditioningStomachAgedAnastomosis, SurgicalFemaleHumansLaparoscopyMaleMicrovascular DensityMiddle AgedPostoperative ComplicationsRetrospective StudiesEsophageal cancerEsophagectomyGastric conduitIschemic conditioningNeoangiogenesisPostoperative complications

Identifiers

PMID40342097
PMCPMC12116690

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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.