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Right gastroepiploic artery length determined anastomotic leakage after minimally invasive esophagectomy for esophageal cancer: a prospective cohort study.
Li, Kun-Kun; Wang, Ying-Jian; Zhang, Tai-Ming; Zhang, Liang; Zhao, Shu-Lin; Chen, Liang; Bao, Tao; Zhao, Xiao-Long; Xie, Xian-Feng; Guo, Wei.
Afiliación
  • Li KK; Department of Thoracic Surgery, Daping Hospital, Army Medical University, People's Republic of China.
Int J Surg ; 110(5): 2757-2764, 2024 May 01.
Article en En | MEDLINE | ID: mdl-38349216
ABSTRACT

BACKGROUND:

This prospective cohort study, conducted at a high-volume esophageal cancer center from July 2019 to July 2022, aimed to investigate the link between the right gastroepiploic artery (RGEA) length and anastomotic leakage (AL) rates following minimally invasive esophagectomy (MIE). Real-world data on stomach blood supply in the Chinese population were examined. MATERIALS AND

METHODS:

A total of 516 cases were enrolled, categorized into two groups based on the Youden index-determined optimal cut-off value for the relative length of RGEA (length of RGEA/length of gastric conduit, 64.69%) through ROC

analysis:

Group SR (short RGEA) and Group LR (long RGEA). The primary observation parameter was the relationship between AL incidence and the ratio of direct blood supply from RGEA. Secondary parameters included the mean length of the right gastroepiploic artery, greater curvature, and the connection type between right and left gastroepiploic vessels. Patient data were prospectively recorded in electronic case report forms.

RESULTS:

The study revealed median lengths of 43.60 cm for greater curvature, 43.16 cm for the gastric conduit, and 26.75 cm for RGEA. AL, the most common postoperative complication, showed a significant difference between groups (16.88 vs. 8.84%, P =0.01). Multivariable binary logistic regression identified Group SR and LR (odds ratio 2.651, 95% CI 1.124-6.250, P =0.03) and Neoadjuvant therapy (odds ratio 2.479, 95% CI 1.374-4.473, P =0.00) as independent predictors of AL.

CONCLUSIONS:

The study emphasizes the crucial role of RGEA length in determining AL incidence in MIE for esophageal cancer. Preserving RGEA and fostering capillary arches between RGEA and LGEA are recommended strategies to mitigate AL risk.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Neoplasias Esofágicas / Esofagectomía / Arteria Gastroepiploica / Fuga Anastomótica Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Int J Surg Año: 2024 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Neoplasias Esofágicas / Esofagectomía / Arteria Gastroepiploica / Fuga Anastomótica Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Int J Surg Año: 2024 Tipo del documento: Article