Fashioning esophagogastric anastomosis in robotic Ivor-Lewis esophagectomy: a multicenter experience.

Anastomosis Esophagectomy Esophagogastric Ivor-Lewis Robotic

Journal

Langenbeck's archives of surgery
ISSN: 1435-2451
Titre abrégé: Langenbecks Arch Surg
Pays: Germany
ID NLM: 9808285

Informations de publication

Date de publication:
22 Mar 2024
Historique:
received: 17 09 2023
accepted: 15 03 2024
medline: 22 3 2024
pubmed: 22 3 2024
entrez: 22 3 2024
Statut: epublish

Résumé

The aim of the present study is to compare outcomes of the robotic hand-sewn, linear- and circular-stapled techniques performed to create an intrathoracic esophagogastric anastomosis in patients who underwent Ivor-Lewis esophagectomy. Patients who underwent a planned Ivor-Lewis esophagectomy were retrospectively analysed from prospectively maintained databases. Only patients who underwent a robotic thoracic approach with the creation of an intrathoracic esophagogastric anastomosis were included in the study. Patients were divided into three groups: hand-sewn-, circular stapled-, and linear-stapled anastomosis group. Demographic information and surgery-related data were extracted. The primary outcome was the rate of anastomotic leakages (AL) in the three groups. Moreover, the rate of grade A, B and C anastomotic leakage were evaluated. In addition, patients of each group were divided in subgroups according to the characteristics of anastomotic fashioning technique. Two hundred and thirty patients were enrolled in the study. No significant differences were found between the three groups about AL rate (p = 0.137). Considering the management of the AL for each of the three groups, no significant differences were found. Evaluating the correlation between AL rate and the characteristics of anastomotic fashioning technique, no significant differences were found. No standardized anastomotic fashioning technique has yet been generally accepted. This study could be considered a call to perform ad hoc high-quality studies involving high-volume centers for upper gastrointestinal surgery to evaluate what is the most advantageous anastomotic technique.

Sections du résumé

BACKGROUND BACKGROUND
The aim of the present study is to compare outcomes of the robotic hand-sewn, linear- and circular-stapled techniques performed to create an intrathoracic esophagogastric anastomosis in patients who underwent Ivor-Lewis esophagectomy.
METHODS METHODS
Patients who underwent a planned Ivor-Lewis esophagectomy were retrospectively analysed from prospectively maintained databases. Only patients who underwent a robotic thoracic approach with the creation of an intrathoracic esophagogastric anastomosis were included in the study. Patients were divided into three groups: hand-sewn-, circular stapled-, and linear-stapled anastomosis group. Demographic information and surgery-related data were extracted. The primary outcome was the rate of anastomotic leakages (AL) in the three groups. Moreover, the rate of grade A, B and C anastomotic leakage were evaluated. In addition, patients of each group were divided in subgroups according to the characteristics of anastomotic fashioning technique.
RESULTS RESULTS
Two hundred and thirty patients were enrolled in the study. No significant differences were found between the three groups about AL rate (p = 0.137). Considering the management of the AL for each of the three groups, no significant differences were found. Evaluating the correlation between AL rate and the characteristics of anastomotic fashioning technique, no significant differences were found.
CONCLUSIONS CONCLUSIONS
No standardized anastomotic fashioning technique has yet been generally accepted. This study could be considered a call to perform ad hoc high-quality studies involving high-volume centers for upper gastrointestinal surgery to evaluate what is the most advantageous anastomotic technique.

Identifiants

pubmed: 38517543
doi: 10.1007/s00423-024-03290-3
pii: 10.1007/s00423-024-03290-3
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

103

Informations de copyright

© 2024. The Author(s).

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Auteurs

Marco Milone (M)

Department of Clinical Medicine and Surgery, ″Federico II″ University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy.

Paolo Pietro Bianchi (PP)

Department of Health Science, University of Milan, 20142, Milan, Italy.

Fabio Cianchi (F)

Chirurgia Dell'Apparato Digerente Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.

Andrea Coratti (A)

Misericordia Hospital of Grosseto, Grosseto, Italy.

Anna D'Amore (A)

Department of Clinical Medicine and Surgery, ″Federico II″ University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy. anna.damore1993@libero.it.

Giovanni De Manzoni (G)

General and Upper GI Surgery Division, Department of Surgery, University of Verona, Verona, Italy.

Carlo Alberto De Pasqual (CA)

General and Upper GI Surgery Division, Department of Surgery, University of Verona, Verona, Italy.

Giampaolo Formisano (G)

Department of Health Science, University of Milan, 20142, Milan, Italy.

Elio Jovine (E)

Department of General Surgery, IRCCS, Azienda Ospedaliero-Universitaria Di Bologna, Maggiore Hospital, 40133, Bologna, Italy.

Luca Morelli (L)

General Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.

Mariafortuna Offi (M)

Department of General Surgery, IRCCS, Azienda Ospedaliero-Universitaria Di Bologna, Maggiore Hospital, 40133, Bologna, Italy.

Andrea Peri (A)

Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Department of Surgery, University of Pavia, Pavia, Italy.

Andrea Pietrabissa (A)

Department of Surgery, University of Pavia, Pavia, Italy.

Fabio Staderini (F)

Chirurgia Dell'Apparato Digerente Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.

Angela Tribuzi (A)

Misericordia Hospital of Grosseto, Grosseto, Italy.

Simone Giacopuzzi (S)

General and Upper GI Surgery Division, Department of Surgery, University of Verona, Verona, Italy.

Classifications MeSH