Esophageal Position Affects Short-Term Outcomes After Minimally Invasive Esophagectomy: A Retrospective Multicenter Study
Background Anatomical esophageal position may affect the short-term outcomes after minimally invasive esophagectomy (MIE). A previous single-institutional retrospective study suggested that the presence of a left-sided esophagus (LSE) made MIE more difficult and increased the incidence of postoperat...
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| Veröffentlicht in: | World journal of surgery 2020-03, Vol.44 (3), p.831-837 |
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| creator | Uchihara, Tomoyuki Yoshida, Naoya Baba, Yoshifumi Nakashima, Yuichiro Kimura, Yasue Saeki, Hiroshi Takeno, Shinsuke Sadanaga, Noriaki Ikebe, Masahiko Morita, Masaru Toh, Yasushi Nanashima, Atsushi Maehara, Yoshihiko Baba, Hideo |
| description | Background
Anatomical esophageal position may affect the short-term outcomes after minimally invasive esophagectomy (MIE). A previous single-institutional retrospective study suggested that the presence of a left-sided esophagus (LSE) made MIE more difficult and increased the incidence of postoperative complications.
Methods
The current study was a multicenter retrospective study of 303 patients with esophageal cancer who underwent MIE at six esophageal cancer high-volume centers in Kyushu, Japan, between April 2011 and August 2016. The patients were divided into the LSE (66 patients) and non-LSE groups (237 patients) based on the esophageal position on computed tomography images obtained with the patients in the supine position.
Results
Univariate analysis showed that patients with LSE were significantly older than those with non-LSE (69 ± 8 vs. 65 ± 9 years;
P
= 0.002), had a significantly greater incidence of cardiovascular comorbidity (65.2% vs. 47.7%;
P
= 0.013), and a significantly longer operating time (612 ± 112 vs. 579 ± 102 min;
P
= 0.025). Logistic regression analysis verified that LSE was an independent risk factor for the incidence of pneumonia (odds ratio 3.3, 95% confidence interval 1.254–8.695;
P
= 0.016).
Conclusions
The presence of a LSE can increase the procedural difficulty of MIE and the incidence of morbidity after MIE. Thus, careful attention must be paid to anatomical esophageal position before performing MIE. |
| doi_str_mv | 10.1007/s00268-019-05273-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2313377312</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2357207954</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4929-ad5efffa8624d1911dca9766419db780a996a5705e0fbe99a2f1f4b91ebf1d893</originalsourceid><addsrcrecordid>eNqNkUFv1DAQhS0EokvhD3BAlrhwCXjsJI57W6oWiloVsUUcLScZt6mSeLGdovx7HNKCxAFxsjXzvaeZeYS8BPYWGJPvAmO8rDIGKmMFlyKrHpEN5IJnXHDxmGyYKPP0B3FAnoVwyxjIkpVPyYEAyQAKuSHzSXD7G3ONpqefXehi50a6tRabGOjuxvmYXaEf6OUUGzdgSL2Inl50YzeYvp_p2XhnQneH9MGoiW6Yj-iWfsHoXdinwtK-mPrYNTgu6l2c2vk5eWJNH_DF_XtIvp6eXB1_zM4vP5wdb8-zJldcZaYt0FprqpLnLSiAtjFKlmUOqq1lxYxSpSkkK5DZGpUy3ILNawVYW2grJQ7Jm9V37933CUPUQxca7HszopuCXu4jpBTAE_r6L_TWTX5M0yWqkJxJVeSJ4ivVpPWCR6v3Ph3DzxqYXoLRazA6BaN_BaOrJHp1bz3VA7a_JQ9JJOBoBX50Pc7_Yam_fdq9P01ltewoVnFIuvEa_Z_B_zHTTywLq0o</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2357207954</pqid></control><display><type>article</type><title>Esophageal Position Affects Short-Term Outcomes After Minimally Invasive Esophagectomy: A Retrospective Multicenter Study</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>SpringerLink Journals</source><creator>Uchihara, Tomoyuki ; Yoshida, Naoya ; Baba, Yoshifumi ; Nakashima, Yuichiro ; Kimura, Yasue ; Saeki, Hiroshi ; Takeno, Shinsuke ; Sadanaga, Noriaki ; Ikebe, Masahiko ; Morita, Masaru ; Toh, Yasushi ; Nanashima, Atsushi ; Maehara, Yoshihiko ; Baba, Hideo</creator><creatorcontrib>Uchihara, Tomoyuki ; Yoshida, Naoya ; Baba, Yoshifumi ; Nakashima, Yuichiro ; Kimura, Yasue ; Saeki, Hiroshi ; Takeno, Shinsuke ; Sadanaga, Noriaki ; Ikebe, Masahiko ; Morita, Masaru ; Toh, Yasushi ; Nanashima, Atsushi ; Maehara, Yoshihiko ; Baba, Hideo</creatorcontrib><description>Background
Anatomical esophageal position may affect the short-term outcomes after minimally invasive esophagectomy (MIE). A previous single-institutional retrospective study suggested that the presence of a left-sided esophagus (LSE) made MIE more difficult and increased the incidence of postoperative complications.
Methods
The current study was a multicenter retrospective study of 303 patients with esophageal cancer who underwent MIE at six esophageal cancer high-volume centers in Kyushu, Japan, between April 2011 and August 2016. The patients were divided into the LSE (66 patients) and non-LSE groups (237 patients) based on the esophageal position on computed tomography images obtained with the patients in the supine position.
Results
Univariate analysis showed that patients with LSE were significantly older than those with non-LSE (69 ± 8 vs. 65 ± 9 years;
P
= 0.002), had a significantly greater incidence of cardiovascular comorbidity (65.2% vs. 47.7%;
P
= 0.013), and a significantly longer operating time (612 ± 112 vs. 579 ± 102 min;
P
= 0.025). Logistic regression analysis verified that LSE was an independent risk factor for the incidence of pneumonia (odds ratio 3.3, 95% confidence interval 1.254–8.695;
P
= 0.016).
Conclusions
The presence of a LSE can increase the procedural difficulty of MIE and the incidence of morbidity after MIE. Thus, careful attention must be paid to anatomical esophageal position before performing MIE.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-019-05273-8</identifier><identifier>PMID: 31701157</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Aged ; Cancer ; Cardiac Surgery ; Complications ; Computed tomography ; Confidence intervals ; Esophageal cancer ; Esophageal Neoplasms - surgery ; Esophagectomy - adverse effects ; Esophagectomy - methods ; Esophagus ; Female ; Gastrointestinal surgery ; General Surgery ; Health risk assessment ; Humans ; Incidence ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Minimally Invasive Surgical Procedures - adverse effects ; Minimally Invasive Surgical Procedures - methods ; Morbidity ; Original Scientific Report ; Postoperative Complications - epidemiology ; Regression analysis ; Retrospective Studies ; Risk analysis ; Risk factors ; Statistical analysis ; Supine position ; Surgery ; Thoracic Surgery ; Vascular Surgery</subject><ispartof>World journal of surgery, 2020-03, Vol.44 (3), p.831-837</ispartof><rights>Société Internationale de Chirurgie 2019</rights><rights>2020 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>World Journal of Surgery is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4929-ad5efffa8624d1911dca9766419db780a996a5705e0fbe99a2f1f4b91ebf1d893</citedby><cites>FETCH-LOGICAL-c4929-ad5efffa8624d1911dca9766419db780a996a5705e0fbe99a2f1f4b91ebf1d893</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-019-05273-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-019-05273-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,41464,42533,45550,45551,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31701157$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Uchihara, Tomoyuki</creatorcontrib><creatorcontrib>Yoshida, Naoya</creatorcontrib><creatorcontrib>Baba, Yoshifumi</creatorcontrib><creatorcontrib>Nakashima, Yuichiro</creatorcontrib><creatorcontrib>Kimura, Yasue</creatorcontrib><creatorcontrib>Saeki, Hiroshi</creatorcontrib><creatorcontrib>Takeno, Shinsuke</creatorcontrib><creatorcontrib>Sadanaga, Noriaki</creatorcontrib><creatorcontrib>Ikebe, Masahiko</creatorcontrib><creatorcontrib>Morita, Masaru</creatorcontrib><creatorcontrib>Toh, Yasushi</creatorcontrib><creatorcontrib>Nanashima, Atsushi</creatorcontrib><creatorcontrib>Maehara, Yoshihiko</creatorcontrib><creatorcontrib>Baba, Hideo</creatorcontrib><title>Esophageal Position Affects Short-Term Outcomes After Minimally Invasive Esophagectomy: A Retrospective Multicenter Study</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
Anatomical esophageal position may affect the short-term outcomes after minimally invasive esophagectomy (MIE). A previous single-institutional retrospective study suggested that the presence of a left-sided esophagus (LSE) made MIE more difficult and increased the incidence of postoperative complications.
Methods
The current study was a multicenter retrospective study of 303 patients with esophageal cancer who underwent MIE at six esophageal cancer high-volume centers in Kyushu, Japan, between April 2011 and August 2016. The patients were divided into the LSE (66 patients) and non-LSE groups (237 patients) based on the esophageal position on computed tomography images obtained with the patients in the supine position.
Results
Univariate analysis showed that patients with LSE were significantly older than those with non-LSE (69 ± 8 vs. 65 ± 9 years;
P
= 0.002), had a significantly greater incidence of cardiovascular comorbidity (65.2% vs. 47.7%;
P
= 0.013), and a significantly longer operating time (612 ± 112 vs. 579 ± 102 min;
P
= 0.025). Logistic regression analysis verified that LSE was an independent risk factor for the incidence of pneumonia (odds ratio 3.3, 95% confidence interval 1.254–8.695;
P
= 0.016).
Conclusions
The presence of a LSE can increase the procedural difficulty of MIE and the incidence of morbidity after MIE. Thus, careful attention must be paid to anatomical esophageal position before performing MIE.</description><subject>Abdominal Surgery</subject><subject>Aged</subject><subject>Cancer</subject><subject>Cardiac Surgery</subject><subject>Complications</subject><subject>Computed tomography</subject><subject>Confidence intervals</subject><subject>Esophageal cancer</subject><subject>Esophageal Neoplasms - surgery</subject><subject>Esophagectomy - adverse effects</subject><subject>Esophagectomy - methods</subject><subject>Esophagus</subject><subject>Female</subject><subject>Gastrointestinal surgery</subject><subject>General Surgery</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgical Procedures - adverse effects</subject><subject>Minimally Invasive Surgical Procedures - methods</subject><subject>Morbidity</subject><subject>Original Scientific Report</subject><subject>Postoperative Complications - epidemiology</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Statistical analysis</subject><subject>Supine position</subject><subject>Surgery</subject><subject>Thoracic Surgery</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkUFv1DAQhS0EokvhD3BAlrhwCXjsJI57W6oWiloVsUUcLScZt6mSeLGdovx7HNKCxAFxsjXzvaeZeYS8BPYWGJPvAmO8rDIGKmMFlyKrHpEN5IJnXHDxmGyYKPP0B3FAnoVwyxjIkpVPyYEAyQAKuSHzSXD7G3ONpqefXehi50a6tRabGOjuxvmYXaEf6OUUGzdgSL2Inl50YzeYvp_p2XhnQneH9MGoiW6Yj-iWfsHoXdinwtK-mPrYNTgu6l2c2vk5eWJNH_DF_XtIvp6eXB1_zM4vP5wdb8-zJldcZaYt0FprqpLnLSiAtjFKlmUOqq1lxYxSpSkkK5DZGpUy3ILNawVYW2grJQ7Jm9V37933CUPUQxca7HszopuCXu4jpBTAE_r6L_TWTX5M0yWqkJxJVeSJ4ivVpPWCR6v3Ph3DzxqYXoLRazA6BaN_BaOrJHp1bz3VA7a_JQ9JJOBoBX50Pc7_Yam_fdq9P01ltewoVnFIuvEa_Z_B_zHTTywLq0o</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Uchihara, Tomoyuki</creator><creator>Yoshida, Naoya</creator><creator>Baba, Yoshifumi</creator><creator>Nakashima, Yuichiro</creator><creator>Kimura, Yasue</creator><creator>Saeki, Hiroshi</creator><creator>Takeno, Shinsuke</creator><creator>Sadanaga, Noriaki</creator><creator>Ikebe, Masahiko</creator><creator>Morita, Masaru</creator><creator>Toh, Yasushi</creator><creator>Nanashima, Atsushi</creator><creator>Maehara, Yoshihiko</creator><creator>Baba, Hideo</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>202003</creationdate><title>Esophageal Position Affects Short-Term Outcomes After Minimally Invasive Esophagectomy: A Retrospective Multicenter Study</title><author>Uchihara, Tomoyuki ; Yoshida, Naoya ; Baba, Yoshifumi ; Nakashima, Yuichiro ; Kimura, Yasue ; Saeki, Hiroshi ; Takeno, Shinsuke ; Sadanaga, Noriaki ; Ikebe, Masahiko ; Morita, Masaru ; Toh, Yasushi ; Nanashima, Atsushi ; Maehara, Yoshihiko ; Baba, Hideo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4929-ad5efffa8624d1911dca9766419db780a996a5705e0fbe99a2f1f4b91ebf1d893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdominal Surgery</topic><topic>Aged</topic><topic>Cancer</topic><topic>Cardiac Surgery</topic><topic>Complications</topic><topic>Computed tomography</topic><topic>Confidence intervals</topic><topic>Esophageal cancer</topic><topic>Esophageal Neoplasms - surgery</topic><topic>Esophagectomy - adverse effects</topic><topic>Esophagectomy - methods</topic><topic>Esophagus</topic><topic>Female</topic><topic>Gastrointestinal surgery</topic><topic>General Surgery</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Minimally Invasive Surgical Procedures - adverse effects</topic><topic>Minimally Invasive Surgical Procedures - methods</topic><topic>Morbidity</topic><topic>Original Scientific Report</topic><topic>Postoperative Complications - epidemiology</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Statistical analysis</topic><topic>Supine position</topic><topic>Surgery</topic><topic>Thoracic Surgery</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Uchihara, Tomoyuki</creatorcontrib><creatorcontrib>Yoshida, Naoya</creatorcontrib><creatorcontrib>Baba, Yoshifumi</creatorcontrib><creatorcontrib>Nakashima, Yuichiro</creatorcontrib><creatorcontrib>Kimura, Yasue</creatorcontrib><creatorcontrib>Saeki, Hiroshi</creatorcontrib><creatorcontrib>Takeno, Shinsuke</creatorcontrib><creatorcontrib>Sadanaga, Noriaki</creatorcontrib><creatorcontrib>Ikebe, Masahiko</creatorcontrib><creatorcontrib>Morita, Masaru</creatorcontrib><creatorcontrib>Toh, Yasushi</creatorcontrib><creatorcontrib>Nanashima, Atsushi</creatorcontrib><creatorcontrib>Maehara, Yoshihiko</creatorcontrib><creatorcontrib>Baba, Hideo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Uchihara, Tomoyuki</au><au>Yoshida, Naoya</au><au>Baba, Yoshifumi</au><au>Nakashima, Yuichiro</au><au>Kimura, Yasue</au><au>Saeki, Hiroshi</au><au>Takeno, Shinsuke</au><au>Sadanaga, Noriaki</au><au>Ikebe, Masahiko</au><au>Morita, Masaru</au><au>Toh, Yasushi</au><au>Nanashima, Atsushi</au><au>Maehara, Yoshihiko</au><au>Baba, Hideo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Esophageal Position Affects Short-Term Outcomes After Minimally Invasive Esophagectomy: A Retrospective Multicenter Study</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2020-03</date><risdate>2020</risdate><volume>44</volume><issue>3</issue><spage>831</spage><epage>837</epage><pages>831-837</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Background
Anatomical esophageal position may affect the short-term outcomes after minimally invasive esophagectomy (MIE). A previous single-institutional retrospective study suggested that the presence of a left-sided esophagus (LSE) made MIE more difficult and increased the incidence of postoperative complications.
Methods
The current study was a multicenter retrospective study of 303 patients with esophageal cancer who underwent MIE at six esophageal cancer high-volume centers in Kyushu, Japan, between April 2011 and August 2016. The patients were divided into the LSE (66 patients) and non-LSE groups (237 patients) based on the esophageal position on computed tomography images obtained with the patients in the supine position.
Results
Univariate analysis showed that patients with LSE were significantly older than those with non-LSE (69 ± 8 vs. 65 ± 9 years;
P
= 0.002), had a significantly greater incidence of cardiovascular comorbidity (65.2% vs. 47.7%;
P
= 0.013), and a significantly longer operating time (612 ± 112 vs. 579 ± 102 min;
P
= 0.025). Logistic regression analysis verified that LSE was an independent risk factor for the incidence of pneumonia (odds ratio 3.3, 95% confidence interval 1.254–8.695;
P
= 0.016).
Conclusions
The presence of a LSE can increase the procedural difficulty of MIE and the incidence of morbidity after MIE. Thus, careful attention must be paid to anatomical esophageal position before performing MIE.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>31701157</pmid><doi>10.1007/s00268-019-05273-8</doi><tpages>7</tpages></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; SpringerLink Journals |
| subjects | Abdominal Surgery Aged Cancer Cardiac Surgery Complications Computed tomography Confidence intervals Esophageal cancer Esophageal Neoplasms - surgery Esophagectomy - adverse effects Esophagectomy - methods Esophagus Female Gastrointestinal surgery General Surgery Health risk assessment Humans Incidence Male Medicine Medicine & Public Health Middle Aged Minimally Invasive Surgical Procedures - adverse effects Minimally Invasive Surgical Procedures - methods Morbidity Original Scientific Report Postoperative Complications - epidemiology Regression analysis Retrospective Studies Risk analysis Risk factors Statistical analysis Supine position Surgery Thoracic Surgery Vascular Surgery |
| title | Esophageal Position Affects Short-Term Outcomes After Minimally Invasive Esophagectomy: A Retrospective Multicenter Study |
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