Reconstruction Techniques and Associated Morbidity in Minimally Invasive Gastrectomy for Cancer

Marcel Andre Schneider; Jeesun Kim; Felix Berlth; Yutaka Sugita; Peter P. Grimminger; Bas P. L. Wijnhoven; Hidde Overtoom; Ines Gockel; Rene Thieme; Ewen A. Griffiths; William Butterworth; Henrik Nienhuser; Beat Mueller; Nerma Crnovrsanin; Daniel Gero; Felix Nickel; Suzanne Gisbertz; Mark I. van Berge Henegouwen; Philip H. Pucher; Kashuf Khan; Asif Chaudry; Pranav H. Patel; Manuel Pera; Mariagiulia Dal Cero; Carlos Garcia; Guillermo Martinez Salinas; Paulo Kassab; Osvaldo Antonio Prado Castro; Enrique Norero; Paul Wisniowski; Luke Randall Putnam; Pietro Maria Lombardi; Giovanni Ferrari; Rita Gudaityte; Almantas Maleckas; Leanne Prodehl; Antonio Castaldi; Michel Prudhomme; Hyuk-Joon Lee; Takeshi Sano; Gian Luca Baiocchi; Giovanni De Manzoni; Simone Giacopuzzi; Maria Bencivenga; Riccardo Rosati; Francesco Puccetti; Domenico D'Ugo; Souya Nunobe; Han-Kwang Yang; Christian Alexander Gutschow; GASTRODATA Consortium

doi:10.1097/SLA.0000000000006470

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Reconstruction Techniques and Associated Morbidity in Minimally Invasive Gastrectomy for Cancer

Article de revue

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Reconstruction Techniques and Associated Morbidity in Minimally Invasive Gastrectomy for Cancer

Marcel Andre Schneider, Jeesun Kim, Felix Berlth, Yutaka Sugita, Peter P. Grimminger, Bas P. L. Wijnhoven, Hidde Overtoom, Ines Gockel, Rene Thieme, Ewen A. Griffiths, …

Annals of surgery, Vol.280(5), pp.788-798

01/11/2024

DOI: https://doi.org/10.1097/SLA.0000000000006470

PMID: 39101212

Résumé

Life Sciences & Biomedicine

Science & Technology

Surgery

Objective/Background:Various anastomotic and reconstruction techniques are used for minimally invasive total (miTG) and distal gastrectomy (miDG). Their effects on postoperative morbidity have not been extensively studied.Methods:MiTG and miDG patients were selected from 9356 oncological gastrectomies performed in 2017-2021 in 43 centers. Endpoints included anastomotic leakage (AL) rate and postoperative morbidity tested by multivariable analysis.Results:Three major anastomotic techniques [circular stapled (CS); linear stapled (LS); and hand sewn (HS)], and 3 major bowel reconstruction types [Roux (RX); Billroth I (BI); Billroth II (BII)] were identified in miTG (n=878) and miDG (n=3334). Postoperative complications, including AL (5.2% vs 1.1%), overall (28.7% vs 16.3%), and major morbidity (15.7% vs 8.2%), as well as 90-day mortality (1.6% vs 0.5%) were higher after miTG compared with miDG. After miTG, the AL rate was higher after CS (4.3%) and HS (7.9%) compared with LS (3.4%). Similarly, major complications (LS: 9.7%, CS: 16.2%, and HS: 12.7%) were lowest after LS. Multivariate analysis confirmed anastomotic technique as a predictive factor for AL, overall, and major complications. In miDG, AL rate (BI: 1.4%, BII 0.8%, and RX 1.2%), overall (BI: 14.5%, BII: 15.0%, and RX: 18.7%), and major morbidity (BI: 7.9%, BII: 9.1%, and RX: 7.2%), and mortality (BI: 0%, BII: 0.1%, and RY: 1.1%%) were not affected by bowel reconstruction.Conclusions:In oncologically suitable situations, miDG should be preferred to miTG, as postoperative morbidity is significantly lower. LS should be a preferred anastomotic technique for miTG in Western Centers. Conversely, bowel reconstruction in DG may be chosen according to the surgeon's preference.

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Titre: Reconstruction Techniques and Associated Morbidity in Minimally Invasive Gastrectomy for Cancer
Créateurs - sans rôle: Marcel Andre Schneider - Univ Hosp Zurich, Dept Surg & Transplantat, Zurich, Switzerland
Jeesun Kim - Seoul Natl Univ Hosp, Dept Surg, Seoul, South Korea
Felix Berlth - Univ Med Ctr Mainz, Dept Gen Visceral and Transplant Surg, Mainz, Germany
Yutaka Sugita - Japanese Fdn Canc Res, Canc Inst Hosp, Dept Gastroenterol Surg, Tokyo, Japan
Peter P. Grimminger - Univ Med Ctr Mainz, Dept Gen Visceral and Transplant Surg, Mainz, Germany
Bas P. L. Wijnhoven - Erasmus MC, Dept Surg Traumatol, Rotterdam, Netherlands
Hidde Overtoom - Erasmus MC, Dept Surg Traumatol, Rotterdam, Netherlands
Ines Gockel - Univ Hosp Leipzig, Dept Visceral Transplant Thorac & Vasc Surg, Leipzig, Germany
Rene Thieme - Univ Hosp Leipzig, Dept Visceral Transplant Thorac & Vasc Surg, Leipzig, Germany
Ewen A. Griffiths - Univ Hosp Birmingham NHS Fdn Trust, Queen Elizabeth Hosp, Dept Upper GI Surg, Birmingham, England
William Butterworth - Univ Hosp Birmingham NHS Fdn Trust, Queen Elizabeth Hosp, Dept Upper GI Surg, Birmingham, England
Henrik Nienhuser - Univ Hosp Heidelberg, Dept Gen Visceral & Transplant Surg, Heidelberg, Germany
Beat Mueller - Univ Hosp Heidelberg, Dept Gen Visceral & Transplant Surg, Heidelberg, Germany
Nerma Crnovrsanin - Univ Hosp Heidelberg, Dept Gen Visceral & Transplant Surg, Heidelberg, Germany
Daniel Gero - Univ Hosp Zurich, Dept Surg & Transplantat, Zurich, Switzerland
Felix Nickel - Univ Med Ctr Hamburg Eppendorf, Dept Gen Visceral & Thorac Surg, Hamburg, Germany
Suzanne Gisbertz - Locat Univ Amsterdam, Amsterdam UMC, Dept Surg, Amsterdam, Netherlands
Mark I. van Berge Henegouwen - Locat Univ Amsterdam, Amsterdam UMC, Dept Surg, Amsterdam, Netherlands
Philip H. Pucher - Canc Ctr Amsterdam, Canc Treatment & Qual Life, Amsterdam, Netherlands
Kashuf Khan - Canc Ctr Amsterdam, Canc Treatment & Qual Life, Amsterdam, Netherlands
Asif Chaudry - Portsmouth Hosp NHS Trust, Queen Alexandra Hosp, Dept Surg, Portsmouth, England
Pranav H. Patel - Portsmouth Hosp NHS Trust, Queen Alexandra Hosp, Dept Surg, Portsmouth, England
Manuel Pera - Royal Marsden NHS Fdn Trust, Gastrointestinal Unit, London, England
Mariagiulia Dal Cero - Royal Marsden NHS Fdn Trust, Gastrointestinal Unit, London, England
Carlos Garcia - Univ Autonoma Barcelona, Hosp Univ Mar, Sect Gastrointestinal Surg, Barcelona, Spain
Guillermo Martinez Salinas - Univ Autonoma Barcelona, Hosp Univ Mar, Sect Gastrointestinal Surg, Barcelona, Spain
Paulo Kassab - Hosp San Borja Arriaran, Dept Surg, Santiago, Region Metropol, Chile
Osvaldo Antonio Prado Castro - Hosp San Borja Arriaran, Dept Surg, Santiago, Region Metropol, Chile
Enrique Norero - St aCasa Sao Paulo Med Sch & Hosp, Dept Surg, Gastroesophageal & Bariatr Surg Div, Sao Paulo, Brazil
Paul Wisniowski - Pontificia Univ Catolica Chile, Esophagogastr Surg Unit, Hosp Dr Sotero del Rio, Digest Surg Dept, Santiago, Chile
Luke Randall Putnam - Pontificia Univ Catolica Chile, Esophagogastr Surg Unit, Hosp Dr Sotero del Rio, Digest Surg Dept, Santiago, Chile
Pietro Maria Lombardi - Univ Southern Calif, Keck Sch Med, Div Upper GI & Gen Surg, Los Angeles, CA USA
Giovanni Ferrari - Univ Southern Calif, Keck Sch Med, Div Upper GI & Gen Surg, Los Angeles, CA USA
Rita Gudaityte - ASST Grande Osped Metropolitano Niguarda, Niguarda Canc Ctr, Div Minimally Invas Surg Oncol, Milan, Italy
Almantas Maleckas - ASST Grande Osped Metropolitano Niguarda, Niguarda Canc Ctr, Div Minimally Invas Surg Oncol, Milan, Italy
Leanne Prodehl - Hosp Lithuanian Univ Hlth Sci, Dept Surg, Kaunas, Lithuania
Antonio Castaldi - Univ Witwatersrand, Charlotte Maxeke Johannesburg Acad Hosp, Dept Surg, Johannesburg, South Africa
Michel Prudhomme - Univ Witwatersrand, Charlotte Maxeke Johannesburg Acad Hosp, Dept Surg, Johannesburg, South Africa
Hyuk-Joon Lee - Seoul Natl Univ Hosp, Dept Surg, Seoul, South Korea
Takeshi Sano - Japanese Fdn Canc Res, Canc Inst Hosp, Dept Gastroenterol Surg, Tokyo, Japan
Gian Luca Baiocchi - Caremeau Univ Hosp, Dept Digest Surg & Digest Oncol, Nimes, France
Giovanni De Manzoni - Univ Hosp Brescia, Dept Surg, Brescia, Italy
Simone Giacopuzzi - Univ Hosp Brescia, Dept Surg, Brescia, Italy
Maria Bencivenga - Univ Hosp Brescia, Dept Surg, Brescia, Italy
Riccardo Rosati - Univ Hosp Verona, Dept Surg, Verona, Italy
Francesco Puccetti - Univ Hosp Verona, Dept Surg, Verona, Italy
Domenico D'Ugo - IRCCS San Raffaele Sci Inst, Dept Surg, Milan, Italy
Souya Nunobe - Japanese Fdn Canc Res, Canc Inst Hosp, Dept Gastroenterol Surg, Tokyo, Japan
Han-Kwang Yang - Seoul Natl Univ Hosp, Dept Surg, Seoul, South Korea
Christian Alexander Gutschow - Univ Hosp Zurich, Dept Surg & Transplantat, Zurich, Switzerland
GASTRODATA Consortium
Détails de publication: Annals of surgery, Vol.280(5), pp.788-798
Éditeur: Lippincott Williams & Wilkins
Nombre de pages: 11
Identifiants: 99153888609311
Unité académique: Initial MAnagement & prevent of acute orGan failures IN critically ill patiEnts - IMAGINE
Langue: English
Type de ressource: Journal article