Operative time in esophagectomy: Does it affect outcomes?

Valsangkar, Nakul P.; Salfity, Hai; Timsina, Lava; Ceppa, DuyKhanh P.; Ceppa, Eugene P.; Birdas, Thomas J.

doi:10.1016/j.surg.2018.06.020

Cited by 30 publications

(21 citation statements)

References 14 publications

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“…Even with all improvements in postoperative cancer surgery care, operative time remains an important and often overlooked predictor of complications. It has been recently associated with morbidity after transhiatal and Ivor Lewis esophagectomies, and it was an independent predictor of major morbidity in a Korean series, along with pulmonary and cardiovascular comorbidities . The impact of operative time is likely to be felt mostly among patients with worse performance status and in low‐volume institutions, where mortality is historically higher …”

Section: Discussionmentioning

confidence: 99%

Predicting overall and major postoperative morbidity in gastric cancer patients

Coimbra

Jesus

Franco

et al. 2019

Journal of Surgical Oncology

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Background Postoperative complications after gastric cancer resection vary in different series and they might have a significant impact in long‐term outcomes. Our aim was to build a prediction rule on gastric cancer patients' overall and major morbidity risks. Methods This retrospective study included 1223 patients from a single center who were resected between 1992 and 2016. Overall and major morbidity predictors were identified through multiple logistic regression. Models' performances were assessed through discrimination, calibration, and cross‐validation, and nomograms were constructed. Results The mean age was 61.3‐year old and the male gender was more frequent (60%). The most common comorbidities were hypertension (HTN), diabetes, and chronic obstructive pulmonary disease (COPD). A D2‐distal gastrectomy was the most frequent procedure and 87% of all lesions were located in the middle or distal third. Age, COPD, coronary heart disease, chronic liver disease, pancreatic resection, and operative time were independent predictors of overall and major morbidity. The extent of resection and splenectomy was associated with overall events and HTN with major ones. Both models were very effective in predicting events among patients at higher risk. Conclusions The overall and major morbidity models and nomograms included clinical‐ and surgical‐related data that were very effective in predicting events, especially for high‐risk patients.

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Section: Discussionmentioning

confidence: 99%

Predicting overall and major postoperative morbidity in gastric cancer patients

Coimbra

Jesus

Franco

et al. 2019

Journal of Surgical Oncology

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“…Furthermore, prolonged operating time has an independent adverse impact on postoperative morbidity and using two robotic systems at the same time might reduce complications. 8 There are some limitations in this preliminary study. The procedures were performed in cadavers and docking a DaVinci X and DaVinci SP simultaneously in a patient might require well-trained staff and surgeons.…”

Section: Discussionmentioning

confidence: 88%

“…5 Prolonged operating time has an independent adverse impact on postoperative morbidity. 8 Reducing operating time by the use of two robotic systems simultaneously could probably result in better postoperative outcomes for patients undergoing esophagectomy. 8 The aim of this cadaver study was to show the feasibility of a fully robotic McKeown esophagectomy in simultaneous rendezvous technique with the DaVinci X (transhiatal) and DaVinci SP (transcervical).…”

Section: Introductionmentioning

confidence: 99%

Transcervical (SP) and Transhiatal DaVinci Robotic Esophagectomy: A Cadaveric Study

Sluis

Egberts

Stein

et al. 2020

Thorac Cardiovasc Surg

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Background This is a preclinical cadaveric study to investigate the feasibility of a fully robotic McKeown esophagectomy in simultaneous rendezvous technique using the DaVinci X for transhiatal dissection and the DaVinci single port (SP) for transcervical dissection. Methods Two transcervical esophagectomies with the DaVinci SP surgical system were performed as training procedures. In the third transcervical cadaveric procedure, the DaVinci SP was installed for the transcervical approach and the DaVinci X surgical system for the abdominal transhiatal phase. Primary outcomes were operating time and lymphadenectomy. Results The mobilization of the esophagus was successfully completed in 118 minutes by using the DaVinci SP for the transcervical phase and the DaVinci X for the transhiatal abdominal phase simultaneously. In total 18 lymph nodes were dissected in the thorax; 3 were located paratracheal right, 3 paratracheal left, 4 subcarinal, 4 para-aortic, 2 paraesophageal upper mediastinal, and 2 paraesophageal middle mediastinal. Conclusion This preclinical study demonstrated that a fully robotic McKeown esophagectomy in simultaneous rendezvous technique using the DaVinci X for transhiatal dissection and the DaVinci SP for transcervical dissection was feasible with adequate lymphadenectomy in a cadaver model. Future research will elucidate the indications for the use of the fully robotic transhiatal and transcervical esophagectomy.

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“…Operative time is an important factor in all fields of surgery, and it is known to relate to postoperative outcomes and incidence of SSI [76,77]. Within transplantation surgery, both cold ischemic time and warm ischemic time are known to impact graft outcomes, with prolonged cold ischemic time associated with reduced pancreatic graft survival [78][79][80].…”

Section: Operative Techniquesmentioning

confidence: 99%

Working towards an ERAS Protocol for Pancreatic Transplantation: A Narrative Review

Elango

Papalois

2021

JCM

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Enhanced recovery after surgery (ERAS) initially started in the early 2000s as a series of protocols to improve the perioperative care of surgical patients. They aimed to increase patient satisfaction while reducing postoperative complications and postoperative length of stay. Despite these protocols being widely adopted in many fields of surgery, they are yet to be adopted in pancreatic transplantation: a high-risk surgery with often prolonged length of postoperative stay and high rate of complications. We have analysed the literature in pancreatic and transplantation surgery to identify the necessary preoperative, intra-operative and postoperative components of an ERAS pathway in pancreas transplantation.

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Operative time in esophagectomy: Does it affect outcomes?

Cited by 30 publications

References 14 publications

Predicting overall and major postoperative morbidity in gastric cancer patients

Predicting overall and major postoperative morbidity in gastric cancer patients

Transcervical (SP) and Transhiatal DaVinci Robotic Esophagectomy: A Cadaveric Study

Working towards an ERAS Protocol for Pancreatic Transplantation: A Narrative Review

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