Guoyuan Ma1, Hongxin Cao2, Ran Wei1, Xiao Qu1, Liguang Wang1, Linhai Zhu1, Jiajun Du3, Yibing Wang4. 1. Department of Thoracic Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, P.R. China. 2. Department of Institute of Oncology, Provincial Hospital Affiliated to Shandong University, Jinan, P.R. China. 3. Department of Thoracic Surgery; Department of Institute of Oncology, Provincial Hospital Affiliated to Shandong University, Jinan, P.R. China. 4. Department of Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, P.R. China.
Abstract
OBJECTIVE: Esophagectomies are associated with high mortality and various complications. Previous studies reported on the short-term outcomes were heterogeneous and inconsistent in comparing minimally invasive esophagectomy (MIE) with traditional open esophagectomy (OE). The objective of this study is to compare the short-term outcomes between MIE and OE calculated using Comprehensive Complication Index (CCI) which incorporates all complication severities. MATERIALS AND METHODS: We did expertise-based randomized controlled trial from September 2014 to October 2015. A total of 144 patients with resectable cancer were randomly selected to be treated by OE or MIE. The CCI was calculated using the Clavien-Dindo classification grade of all postoperative complications collected. Demographic characteristics, preoperative clinical assessment, postoperative complications, and CCI of patients were compared between both groups. RESULTS: Among the 144 patients included in this study, 97 underwent OE and 47 underwent MIE. Demographics, preoperative clinical assessment, and inpatient mortality in both cohorts were almost identical. Eighty-four patients (86.6%) of OE group and 26 patients (55.3%) of MIE group suffered from complications. A significant difference was observed in blood transfusion (P = 0.04), moderate and severe pain (P < 0.01), and diarrhea (P = 0.03) between two groups. There was an obvious statistical significance of CCI between OE and MIE groups (P = 0.036). CONCLUSIONS: The CCI is a promising scoring system that could be used to assess the severity of complications after esophagectomy. MIE could improve the short-term outcomes by reducing some mild and moderate complications.
OBJECTIVE: Esophagectomies are associated with high mortality and various complications. Previous studies reported on the short-term outcomes were heterogeneous and inconsistent in comparing minimally invasive esophagectomy (MIE) with traditional open esophagectomy (OE). The objective of this study is to compare the short-term outcomes between MIE and OE calculated using Comprehensive Complication Index (CCI) which incorporates all complication severities. MATERIALS AND METHODS: We did expertise-based randomized controlled trial from September 2014 to October 2015. A total of 144 patients with resectable cancer were randomly selected to be treated by OE or MIE. The CCI was calculated using the Clavien-Dindo classification grade of all postoperative complications collected. Demographic characteristics, preoperative clinical assessment, postoperative complications, and CCI of patients were compared between both groups. RESULTS: Among the 144 patients included in this study, 97 underwent OE and 47 underwent MIE. Demographics, preoperative clinical assessment, and inpatient mortality in both cohorts were almost identical. Eighty-four patients (86.6%) of OE group and 26 patients (55.3%) of MIE group suffered from complications. A significant difference was observed in blood transfusion (P = 0.04), moderate and severe pain (P < 0.01), and diarrhea (P = 0.03) between two groups. There was an obvious statistical significance of CCI between OE and MIE groups (P = 0.036). CONCLUSIONS: The CCI is a promising scoring system that could be used to assess the severity of complications after esophagectomy. MIE could improve the short-term outcomes by reducing some mild and moderate complications.
Authors: Rachel C Brierley; Daisy Gaunt; Chris Metcalfe; Jane M Blazeby; Natalie S Blencowe; Marcus Jepson; Richard G Berrisford; Kerry N L Avery; William Hollingworth; Caoimhe T Rice; Aida Moure-Fernandez; Newton Wong; Joanna Nicklin; Anni Skilton; Alex Boddy; James P Byrne; Tim Underwood; Ravi Vohra; James A Catton; Kish Pursnani; Rachel Melhado; Bilal Alkhaffaf; Richard Krysztopik; Peter Lamb; Lucy Culliford; Chris Rogers; Benjamin Howes; Katy Chalmers; Sian Cousins; Jackie Elliott; Jenny Donovan; Rachael Heys; Robin A Wickens; Paul Wilkerson; Andrew Hollowood; Christopher Streets; Dan Titcomb; Martyn Lee Humphreys; Tim Wheatley; Grant Sanders; Arun Ariyarathenam; Jamie Kelly; Fergus Noble; Graeme Couper; Richard J E Skipworth; Chris Deans; Sukhbir Ubhi; Robert Williams; David Bowrey; David Exon; Paul Turner; Vinutha Daya Shetty; Ram Chaparala; Khurshid Akhtar; Naheed Farooq; Simon L Parsons; Neil T Welch; Rebecca J Houlihan; Joanne Smith; Rachel Schranz; Nicola Rea; Jill Cooke; Alexandra Williams; Carolyn Hindmarsh; Sally Maitland; Lucy Howie; Christopher Paul Barham Journal: BMJ Open Date: 2019-11-19 Impact factor: 2.692
Authors: Lajos Szakó; Dávid Németh; Nelli Farkas; Szabolcs Kiss; Réka Zsuzsa Dömötör; Marie Anne Engh; Péter Hegyi; Balint Eross; András Papp Journal: World J Gastroenterol Date: 2022-08-14 Impact factor: 5.374