Laparoscopic-assisted Esophageal Bypass for T4b Esophageal Tumor as a Bridge to Definitive Therapy

Davakis, Spyridon; Syllaios, Athanasios; Mpaili, Efstratia; Liakakos, Theodoros; Charalabopoulos, Alexandros

doi:10.21873/invivo.12024

Cited by 1 publication

(3 citation statements)

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“…Although bypass surgery using a gastric conduit is the primary technique, 16,28 small bowel and colon conduits can also be used for surgical bypass. 29 Third, indications for bypass surgery and stent insertion can be different,that is, the former is for candidates for chemotherapy and/or radiotherapy, [16][17][18] whereas the latter is for patients with limited prognoses. [9][10][11]…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14][15] Esophageal bypass surgery is another alternative that enables oral intake and additional treatment, including chemotherapy and radiotherapy. [16][17][18] The incidence of postoperative complications of esophageal bypass surgery is relatively high. 19,20 However, esophageal bypass surgery can be performed for patients with a high risk of postoperative complications, such as perforations and bleeding, if stent insertion is performed.…”

mentioning

confidence: 99%

“…It is minimally invasive; however, it is associated with risks of severe life-threatening complications, such as massive bleeding and esophageal perforation, particularly when combined with chemotherapy and/or radiotherapy 12–15 . Esophageal bypass surgery is another alternative that enables oral intake and additional treatment, including chemotherapy and radiotherapy 16–18 . The incidence of postoperative complications of esophageal bypass surgery is relatively high 19,20 .…”

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confidence: 99%

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Comparison of Short-term Outcomes Between Esophageal Bypass Surgery and Self-expanding Stent Insertion in Esophageal Cancer: A Propensity Score-matched Analysis Using a Large-scale Inpatient Database

Yamamoto,

Kitazawa,

Otsubo

et al. 2023

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Advanced esophageal cancer is occasionally accompanied by difficulty swallowing owing to esophageal stenosis or tracheoesophageal fistula formation. Esophageal bypass surgery and stent insertion are considered feasible palliative management options. The aim of this study was to evaluate the short-term outcomes of these palliative treatments. Materials and Methods: Patient data were obtained from a large-scale inpatient database of 42 National University Hospitals in Japan. Patients with advanced esophageal cancer who underwent esophageal bypass surgery or stent insertion between April 2016 and March 2021 were included in this study. One-to-one propensity score matching of patients who underwent bypass surgery or stent insertion was performed. The primary outcomes were time to diet resumption and length of hospital stay after surgery. The secondary outcome was the incidence of postoperative complications. Results: In 43 propensity score-matched pairs, the incidence of postoperative respiratory complications was significantly higher in the bypass group than in the stent group (32.6% vs. 9.3%, P = 0.008). Postoperative length of hospital stay was longer in the bypass group than in the stent group (24 vs. 10 d, P < 0.001). Logistic regression analysis revealed that stent insertion was associated with a decreased risk of respiratory complications (odds ratio 0.077, P < 0.007). Among patients who underwent the interventions (bypass surgery or stent insertion) and subsequently underwent anticancer therapy (chemotherapy/radiotherapy) during hospitalization, the interval between the intervention and anticancer therapy was longer in the bypass group than in the stent group (25 vs. 7 d, P = 0.003). Conclusions: Esophageal stent insertion provides better short-term outcomes than bypass surgery in patients with advanced unresectable esophageal cancer.

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