Treatment of anastomotic leak after oesophagectomy for oesophageal cancer: large, collaborative, observational TENTACLE cohort study
| Title: | Treatment of anastomotic leak after oesophagectomy for oesophageal cancer: large, collaborative, observational TENTACLE cohort study |
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| Authors: | Ubels S.; Verstegen M. H. P.; Klarenbeek B. R.; Bouwense S.; van Berge Henegouwen M. I.; Daams F.; van Det M. J.; Griffiths E. A.; Haveman J. W.; Heisterkamp J.; Nieuwenhuijzen G.; Polat F.; Schouten J.; Siersema P. D.; Singh P.; Wijnhoven B.; Hannink G.; van Workum F.; Rosman C.; Matthee E.; Slootmans C. A. M.; Ultee G.; Gisbertz S. S.; Eshuis W. J.; Kalff M. C.; Feenstra M. L.; van der Peet D. L.; Stam W. T.; Van Etten B.; Poelmann F.; Vuurberg N.; van den Berg J. W.; Martijnse I. S.; Matthijsen R. M.; Luyer M.; Curvers W.; Nieuwenhuijzen T.; Taselaar A. E.; Kouwenhoven E. A.; Lubbers M.; Sosef M.; Lecot F.; Geraedts T. C. M.; van Esser S.; Dekker J. W. T.; van den Wildenberg F.; Kelder W.; Baas P. C.; de Haas J. W. A.; Hartgrink H. H.; Bahadoer R. R.; van Sandick J. W.; Hartemink K. J.; Veenhof X.; Stockmann H.; Gorgec B.; Weeder P.; Wiezer M. J.; Genders C. M. S.; Belt E.; Blomberg B.; van Duijvendijk P.; Claassen L.; Reetz D.; Steenvoorde P.; Mastboom W.; Ganseij H. J. K.; van Dalsen A. D.; Joldersma A.; Zwakman M.; Groenendijk R. P. R.; Montazeri M.; Mercer S.; Knight B.; van Boxel G.; McGregor R. J.; Skipworth R. J. E.; Frattini C.; Bradley A.; Nilsson M.; Hayami M.; Huang B.; Bundred J.; Evans R.; Grimminger P. P.; van Der Sluis P. C.; Eren U.; Saunders J.; Theophilidou E.; Khanzada Z.; Elliott J. A.; Ponten J. E. H.; King S.; Reynolds J. V.; Sgromo B.; Akbari K.; Shalaby S.; Gutschow C. A.; Schmidt H.; Vetter D.; Moorthy K.; Ibrahim M. A. H.; Christodoulidis G.; Rasanen J. V.; Kauppi J.; Soderstrom H.; Koshy R.; Manatakis D. K.; Korkolis D. P.; Balalis D.; Rompu A.; Alkhaffaf B.; Alasmar M.; Arebi M.; Piessen G.; Nuytens F.; Degisors S.; Ahmed A.; Boddy A.; Gandhi S.; Fashina O.; Van Daele E.; Pattyn P.; Robb W. B.; Arumugasamy M.; Al Azzawi M.; Whooley J.; Colak E.; Aybar E.; Sari A. C.; Uyanik M. S.; Ciftci A. B.; Sayyed R.; Ayub B.; Murtaza G.; Saeed A.; Ramesh P.; Charalabopoulos A.; Liakakos T.; Schizas D.; Baili E.; Kapelouzou A.; Valmasoni M.; Pierobon E. S.; Capovilla G.; Merigliano S.; Constantinoiu S.; Birla R.; Achim F.; Rosianu C. G.; Hoara P.; Castro R. G.; Salcedo A. F.; Negoi I.; Negoita V. M.; Ciubotaru C.; Stoica B.; Hostiuc S.; Colucci N.; Monig S. P.; Wassmer C. -H.; Meyer J.; Takeda F. R.; Sallum R. A. A.; Ribeiro U.; Cecconello I.; Toledo E.; Trugeda M. S.; Fernandez M. J.; Gil C.; Castanedo S.; Isik A.; Kurnaz E.; Videira J. F.; Peyroteo M.; Canotilho R.; Weindelmayer J.; Giacopuzzi S.; De Pasqual C. A.; Bruna M.; Mingol F.; Vaque J.; Perez C.; Phillips A. W.; Chmelo J.; Brown J.; Han L. E.; Gossage J. A.; Davies A. R.; Baker C. R.; Kelly M.; Saad M.; Bernardi D.; Bonavina L.; Asti E.; Riva C.; Scaramuzzo R.; Elhadi M.; Ahmed H. A.; Elhadi A.; Elnagar F. A.; Msherghi A. A. A.; Wills V.; Campbell C.; Cerdeira M. P.; Whiting S.; Merrett N.; Das A.; Apostolou C.; Lorenzo A.; Sousa F.; Barbosa J. A.; Devezas V.; Barbosa E.; Fernandes C.; Smith G.; Li E. Y.; Bhimani N.; Chan P.; Kotecha K.; Hii M. W.; Ward S. M.; Johnson M.; Read M.; Chong L.; Hollands M. J.; Allaway M.; Richardson A.; Johnston E.; Chen A. Z. L.; Kanhere H.; Prasad S.; McQuillan P.; Surman T.; Trochsler M. I.; Schofield W. A.; Ahmed S. K.; Reid J. L.; Harris M. C.; Gananadha S.; Farrant J.; Rodrigues N.; Fergusson J.; Hindmarsh A.; Afzal Z.; Safranek P.; Sujendran V.; Rooney S.; Carlos Loureiro; Saioa Leturio Fernandez; del Val I. D.; Jaunoo S.; Kennedy L.; Hussain A.; Theodorou D.; Triantafyllou T.; Theodoropoulos C.; Palyvou T.; Ben Taher F. A.; Ekheel M. |
| Contributors: | Ubels, S.; Verstegen, M. H. P.; Klarenbeek, B. R.; Bouwense, S.; Van Berge Henegouwen, M. I.; Daams, F.; Van Det, M. J.; Griffiths, E. A.; Haveman, J. W.; Heisterkamp, J.; Nieuwenhuijzen, G.; Polat, F.; Schouten, J.; Siersema, P. D.; Singh, P.; Wijnhoven, B.; Hannink, G.; Van Workum, F.; Rosman, C.; Matthee, E.; Slootmans, C. A. M.; Ultee, G.; Gisbertz, S. S.; Eshuis, W. J.; Kalff, M. C.; Feenstra, M. L.; Van Der Peet, D. L.; Stam, W. T.; Van Etten, B.; Poelmann, F.; Vuurberg, N.; Van Den Berg, J. W.; Martijnse, I. S.; Matthijsen, R. M.; Luyer, M.; Curvers, W.; Nieuwenhuijzen, T.; Taselaar, A. E.; Kouwenhoven, E. A.; Lubbers, M.; Sosef, M.; Lecot, F.; Geraedts, T. C. M.; Van Esser, S.; Dekker, J. W. T.; Van Den Wildenberg, F.; Kelder, W.; Baas, P. C.; De Haas, J. W. A.; Hartgrink, H. H.; Bahadoer, R. R.; Van Sandick, J. W.; Hartemink, K. J.; Veenhof, X.; Stockmann, H.; Gorgec, B.; Weeder, P.; Wiezer, M. J.; Genders, C. M. S.; Belt, E.; Blomberg, B.; Van Duijvendijk, P.; Claassen, L.; Reetz, D.; Steenvoorde, P.; Mastboom, W.; Ganseij, H. J. K.; Van Dalsen, A. D.; Joldersma, A.; Zwakman, M.; Groenendijk, R. P. R.; Montazeri, M.; Mercer, S.; Knight, B.; Van Boxel, G.; Mcgregor, R. J.; Skipworth, R. J. E.; Frattini, C.; Bradley, A.; Nilsson, M.; Hayami, M.; Huang, B.; Bundred, J.; Evans, R.; Grimminger, P. P.; Van Der Sluis, P. C.; Eren, U.; Saunders, J.; Theophilidou, E.; Khanzada, Z.; Elliott, J. A.; Ponten, J. E. H.; King, S.; Reynolds, J. V.; Sgromo, B.; Akbari, K.; Shalaby, S.; Gutschow, C. A.; Schmidt, H. |
| Publisher Information: | Oxford University Press |
| Publication Year: | 2023 |
| Collection: | Padua Research Archive (IRIS - Università degli Studi di Padova) |
| Description: | Background: Anastomotic leak is a severe complication after oesophagectomy. Anastomotic leak has diverse clinical manifestations and the optimal treatment strategy is unknown. The aim of this study was to assess the efficacy of treatment strategies for different manifestations of anastomotic leak after oesophagectomy. Methods: A retrospective cohort study was performed in 71 centres worldwide and included patients with anastomotic leak after oesophagectomy (2011-2019). Different primary treatment strategies were compared for three different anastomotic leak manifestations: interventional versus supportive-only treatment for local manifestations (that is no intrathoracic collections; well perfused conduit); drainage and defect closure versus drainage only for intrathoracic manifestations; and oesophageal diversion versus continuity-preserving treatment for conduit ischaemia/necrosis. The primary outcome was 90-day mortality. Propensity score matching was performed to adjust for confounders. Results: Of 1508 patients with anastomotic leak, 28.2 per cent (425 patients) had local manifestations, 36.3 per cent (548 patients) had intrathoracic manifestations, 9.6 per cent (145 patients) had conduit ischaemia/necrosis, 17.5 per cent (264 patients) were allocated after multiple imputation, and 8.4 per cent (126 patients) were excluded. After propensity score matching, no statistically significant differences in 90-day mortality were found regarding interventional versus supportive-only treatment for local manifestations (risk difference 3.2 per cent, 95 per cent c.i. -1.8 to 8.2 per cent), drainage and defect closure versus drainage only for intrathoracic manifestations (risk difference 5.8 per cent, 95 per cent c.i. -1.2 to 12.8 per cent), and oesophageal diversion versus continuity-preserving treatment for conduit ischaemia/necrosis (risk difference 0.1 per cent, 95 per cent c.i. -21.4 to 1.6 per cent). In general, less morbidity was found after less extensive primary treatment strategies. Conclusion: Less extensive ... |
| Document Type: | article in journal/newspaper |
| Language: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/37196149; info:eu-repo/semantics/altIdentifier/wos/WOS:000988841000001; volume:110; issue:7; firstpage:852; lastpage:863; numberofpages:12; journal:BRITISH JOURNAL OF SURGERY; https://hdl.handle.net/11577/3546147 |
| DOI: | 10.1093/bjs/znad123 |
| Availability: | https://hdl.handle.net/11577/3546147; https://doi.org/10.1093/bjs/znad123 |
| Rights: | info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by-nc/4.0/ |
| Accession Number: | edsbas.78FFEB80 |
| Database: | BASE |