The Influence of Age on Complications and Overall Survival After Ivor Lewis Totally Minimally Invasive Esophagectomy

Background The number of elderly patients suffering from esophageal cancer is increasing, due to an increasing incidence of esophageal cancer and increasing life expectancy. However, the effect of age on morbidity, mortality, and survival after Ivor Lewis total minimally invasive esophagectomy (TMIE...

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Veröffentlicht in:Journal of gastrointestinal surgery 2019-07, Vol.23 (7), p.1293-1300
Hauptverfasser: Baranov, Nikolaj S., van Workum, Frans, van der Maas, Jolijn, Kouwenhoven, Ewout, van Det, Marc, van den Wildenberg, Frits J. H., Polat, Fatih, Nieuwenhuijzen, Grard A. P., Luyer, Misha D. P., Rosman, Camiel
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container_issue 7
container_start_page 1293
container_title Journal of gastrointestinal surgery
container_volume 23
creator Baranov, Nikolaj S.
van Workum, Frans
van der Maas, Jolijn
Kouwenhoven, Ewout
van Det, Marc
van den Wildenberg, Frits J. H.
Polat, Fatih
Nieuwenhuijzen, Grard A. P.
Luyer, Misha D. P.
Rosman, Camiel
description Background The number of elderly patients suffering from esophageal cancer is increasing, due to an increasing incidence of esophageal cancer and increasing life expectancy. However, the effect of age on morbidity, mortality, and survival after Ivor Lewis total minimally invasive esophagectomy (TMIE) is not well known. Methods A prospectively documented database from December 2010 to June 2017 was analyzed, including all patients who underwent Ivor Lewis TMIE for esophageal cancer in three Dutch high-volume esophageal cancer centers. Patients younger than 75 years (younger group) were compared to patients aged 75 years or older (elderly group). Baseline patient characteristics and perioperative data were included. Surgical complications were graded using the Clavien-Dindo scale. The primary outcome was postoperative complications Clavien-Dindo ≥ 3. Secondary outcome parameters were postoperative complications, in-hospital mortality, 30- and 90-day mortality and survival. Results Four hundred and forty-six patients were included, 357 in the younger and 89 in the elderly group. No significant differences were recorded regarding baseline patient characteristics. There was no significant difference in complications graded Clavien-Dindo ≥ 3 and overall complications, short-term mortality, and survival. Delirium occurred in 27.0% in the elderly and 11.8% in the younger group ( p  
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H. ; Polat, Fatih ; Nieuwenhuijzen, Grard A. P. ; Luyer, Misha D. P. ; Rosman, Camiel</creator><creatorcontrib>Baranov, Nikolaj S. ; van Workum, Frans ; van der Maas, Jolijn ; Kouwenhoven, Ewout ; van Det, Marc ; van den Wildenberg, Frits J. H. ; Polat, Fatih ; Nieuwenhuijzen, Grard A. P. ; Luyer, Misha D. P. ; Rosman, Camiel</creatorcontrib><description>Background The number of elderly patients suffering from esophageal cancer is increasing, due to an increasing incidence of esophageal cancer and increasing life expectancy. However, the effect of age on morbidity, mortality, and survival after Ivor Lewis total minimally invasive esophagectomy (TMIE) is not well known. Methods A prospectively documented database from December 2010 to June 2017 was analyzed, including all patients who underwent Ivor Lewis TMIE for esophageal cancer in three Dutch high-volume esophageal cancer centers. Patients younger than 75 years (younger group) were compared to patients aged 75 years or older (elderly group). Baseline patient characteristics and perioperative data were included. Surgical complications were graded using the Clavien-Dindo scale. The primary outcome was postoperative complications Clavien-Dindo ≥ 3. Secondary outcome parameters were postoperative complications, in-hospital mortality, 30- and 90-day mortality and survival. Results Four hundred and forty-six patients were included, 357 in the younger and 89 in the elderly group. No significant differences were recorded regarding baseline patient characteristics. There was no significant difference in complications graded Clavien-Dindo ≥ 3 and overall complications, short-term mortality, and survival. Delirium occurred in 27.0% in the elderly and 11.8% in the younger group ( p  &lt; 0.001). After correction for baseline comorbidity this difference remained significant ( p  = 0.001). Median hospital length of stay was 13 days in the elderly and 11 days in the younger group ( p  = 0.010). Conclusions Ivor Lewis TMIE can be safely performed in selected elderly patients without increasing postoperative morbidity and mortality.</description><identifier>ISSN: 1091-255X</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1007/s11605-018-4062-9</identifier><identifier>PMID: 30565069</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Age Factors ; Aged ; Esophageal cancer ; Esophageal Neoplasms - mortality ; Esophageal Neoplasms - surgery ; Esophagectomy - adverse effects ; Esophagectomy - mortality ; Esophagus ; Female ; Gastroenterology ; Gastrointestinal surgery ; Hospital Mortality ; Humans ; Length of Stay ; Male ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Minimally Invasive Surgical Procedures - adverse effects ; Minimally Invasive Surgical Procedures - mortality ; Mortality ; Original ; Original Article ; Patients ; Postoperative Complications - mortality ; Retrospective Studies ; Surgery ; Survival Rate</subject><ispartof>Journal of gastrointestinal surgery, 2019-07, Vol.23 (7), p.1293-1300</ispartof><rights>The Author(s) 2018</rights><rights>Journal of Gastrointestinal Surgery is a copyright of Springer, (2018). All Rights Reserved. © 2018. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-49443cc623b441b3cf62b011ec4103e094808c47654ac33acd9d93523ae880f83</citedby><cites>FETCH-LOGICAL-c470t-49443cc623b441b3cf62b011ec4103e094808c47654ac33acd9d93523ae880f83</cites><orcidid>0000-0002-8646-2737</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11605-018-4062-9$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11605-018-4062-9$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30565069$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Baranov, Nikolaj S.</creatorcontrib><creatorcontrib>van Workum, Frans</creatorcontrib><creatorcontrib>van der Maas, Jolijn</creatorcontrib><creatorcontrib>Kouwenhoven, Ewout</creatorcontrib><creatorcontrib>van Det, Marc</creatorcontrib><creatorcontrib>van den Wildenberg, Frits J. H.</creatorcontrib><creatorcontrib>Polat, Fatih</creatorcontrib><creatorcontrib>Nieuwenhuijzen, Grard A. P.</creatorcontrib><creatorcontrib>Luyer, Misha D. P.</creatorcontrib><creatorcontrib>Rosman, Camiel</creatorcontrib><title>The Influence of Age on Complications and Overall Survival After Ivor Lewis Totally Minimally Invasive Esophagectomy</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><addtitle>J Gastrointest Surg</addtitle><description>Background The number of elderly patients suffering from esophageal cancer is increasing, due to an increasing incidence of esophageal cancer and increasing life expectancy. However, the effect of age on morbidity, mortality, and survival after Ivor Lewis total minimally invasive esophagectomy (TMIE) is not well known. Methods A prospectively documented database from December 2010 to June 2017 was analyzed, including all patients who underwent Ivor Lewis TMIE for esophageal cancer in three Dutch high-volume esophageal cancer centers. Patients younger than 75 years (younger group) were compared to patients aged 75 years or older (elderly group). Baseline patient characteristics and perioperative data were included. Surgical complications were graded using the Clavien-Dindo scale. The primary outcome was postoperative complications Clavien-Dindo ≥ 3. Secondary outcome parameters were postoperative complications, in-hospital mortality, 30- and 90-day mortality and survival. Results Four hundred and forty-six patients were included, 357 in the younger and 89 in the elderly group. No significant differences were recorded regarding baseline patient characteristics. There was no significant difference in complications graded Clavien-Dindo ≥ 3 and overall complications, short-term mortality, and survival. Delirium occurred in 27.0% in the elderly and 11.8% in the younger group ( p  &lt; 0.001). After correction for baseline comorbidity this difference remained significant ( p  = 0.001). Median hospital length of stay was 13 days in the elderly and 11 days in the younger group ( p  = 0.010). Conclusions Ivor Lewis TMIE can be safely performed in selected elderly patients without increasing postoperative morbidity and mortality.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Esophageal cancer</subject><subject>Esophageal Neoplasms - mortality</subject><subject>Esophageal Neoplasms - surgery</subject><subject>Esophagectomy - adverse effects</subject><subject>Esophagectomy - mortality</subject><subject>Esophagus</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gastrointestinal surgery</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgical Procedures - adverse effects</subject><subject>Minimally Invasive Surgical Procedures - mortality</subject><subject>Mortality</subject><subject>Original</subject><subject>Original Article</subject><subject>Patients</subject><subject>Postoperative Complications - mortality</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Survival Rate</subject><issn>1091-255X</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU1rGzEQhpfS0ny0P6CXIuill21Hq49dXQrGJKnBJYe40JuQ5VlbYVdypd0t_vdR4jT9gJxmYJ55Z17eonhH4RMFqD8nSiWIEmhTcpBVqV4Up7SpWcllJV_mHhQtKyF-nBRnKd0C0Dqzr4sTBkIKkOq0GFY7JAvfdiN6iyS0ZLbNxZN56Peds2ZwwSdi_IZcTxhN15GbMU5uMh2ZtQNGsphCJEv85RJZhSEDB_LNedc_dAs_meQmJBcp7Hdmi3YI_eFN8ao1XcK3j_W8-H55sZp_LZfXV4v5bFlaXsNQcsU5s1ZWbM05XTPbymoNlKLlFBiC4g00GZWCG8uYsRu1UUxUzGDTQNuw8-LLUXc_rnvcWPRDdqD3MX8XDzoYp_-deLfT2zBpKRSlDcsCHx8FYvg5Yhp075LFrjMew5h0RUUjRF0Dz-iH_9DbMEaf7T1QIHitZKbokbIxpBSxfXqGgr7PVB8z1TknfZ-pVnnn_d8unjZ-h5iB6gikPPJbjH9OP696B3n4rUA</recordid><startdate>20190701</startdate><enddate>20190701</enddate><creator>Baranov, Nikolaj S.</creator><creator>van Workum, Frans</creator><creator>van der Maas, Jolijn</creator><creator>Kouwenhoven, Ewout</creator><creator>van Det, Marc</creator><creator>van den Wildenberg, Frits J. H.</creator><creator>Polat, Fatih</creator><creator>Nieuwenhuijzen, Grard A. P.</creator><creator>Luyer, Misha D. P.</creator><creator>Rosman, Camiel</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><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>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-8646-2737</orcidid></search><sort><creationdate>20190701</creationdate><title>The Influence of Age on Complications and Overall Survival After Ivor Lewis Totally Minimally Invasive Esophagectomy</title><author>Baranov, Nikolaj S. ; van Workum, Frans ; van der Maas, Jolijn ; Kouwenhoven, Ewout ; van Det, Marc ; van den Wildenberg, Frits J. 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H.</au><au>Polat, Fatih</au><au>Nieuwenhuijzen, Grard A. P.</au><au>Luyer, Misha D. P.</au><au>Rosman, Camiel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Influence of Age on Complications and Overall Survival After Ivor Lewis Totally Minimally Invasive Esophagectomy</atitle><jtitle>Journal of gastrointestinal surgery</jtitle><stitle>J Gastrointest Surg</stitle><addtitle>J Gastrointest Surg</addtitle><date>2019-07-01</date><risdate>2019</risdate><volume>23</volume><issue>7</issue><spage>1293</spage><epage>1300</epage><pages>1293-1300</pages><issn>1091-255X</issn><eissn>1873-4626</eissn><abstract>Background The number of elderly patients suffering from esophageal cancer is increasing, due to an increasing incidence of esophageal cancer and increasing life expectancy. However, the effect of age on morbidity, mortality, and survival after Ivor Lewis total minimally invasive esophagectomy (TMIE) is not well known. Methods A prospectively documented database from December 2010 to June 2017 was analyzed, including all patients who underwent Ivor Lewis TMIE for esophageal cancer in three Dutch high-volume esophageal cancer centers. Patients younger than 75 years (younger group) were compared to patients aged 75 years or older (elderly group). Baseline patient characteristics and perioperative data were included. Surgical complications were graded using the Clavien-Dindo scale. The primary outcome was postoperative complications Clavien-Dindo ≥ 3. Secondary outcome parameters were postoperative complications, in-hospital mortality, 30- and 90-day mortality and survival. Results Four hundred and forty-six patients were included, 357 in the younger and 89 in the elderly group. No significant differences were recorded regarding baseline patient characteristics. There was no significant difference in complications graded Clavien-Dindo ≥ 3 and overall complications, short-term mortality, and survival. Delirium occurred in 27.0% in the elderly and 11.8% in the younger group ( p  &lt; 0.001). After correction for baseline comorbidity this difference remained significant ( p  = 0.001). Median hospital length of stay was 13 days in the elderly and 11 days in the younger group ( p  = 0.010). Conclusions Ivor Lewis TMIE can be safely performed in selected elderly patients without increasing postoperative morbidity and mortality.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>30565069</pmid><doi>10.1007/s11605-018-4062-9</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-8646-2737</orcidid><oa>free_for_read</oa></addata></record>
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subjects Age Factors
Aged
Esophageal cancer
Esophageal Neoplasms - mortality
Esophageal Neoplasms - surgery
Esophagectomy - adverse effects
Esophagectomy - mortality
Esophagus
Female
Gastroenterology
Gastrointestinal surgery
Hospital Mortality
Humans
Length of Stay
Male
Medicine
Medicine & Public Health
Middle Aged
Minimally Invasive Surgical Procedures - adverse effects
Minimally Invasive Surgical Procedures - mortality
Mortality
Original
Original Article
Patients
Postoperative Complications - mortality
Retrospective Studies
Surgery
Survival Rate
title The Influence of Age on Complications and Overall Survival After Ivor Lewis Totally Minimally Invasive Esophagectomy
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