Esophagectomy outcomes at a mid-volume cancer center utilizing prospective multidisciplinary care and a 2-surgeon team approach

McCahill, Laurence E.; May, Mary; Morrow, Jay Bradley; Khandavalli, Sharif; Shabahang, Behrooz; Kemmeter, Paul; Pimiento, José M.

doi:10.1016/j.amjsurg.2013.09.013

Cited by 12 publications

(6 citation statements)

References 11 publications

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“…Limitations of this study include the retrospective inclusion of cases from only a single high-volume institution. Although some studies suggest that volume alone does not drive lower morbidity and mortality rates after esophagectomy [14], higher esophagectomy case volumes have been shown to be associated with lower rates of complications [4]. Although there is insufficient literature on CER to draw the same conclusions, it is possible that morbidity and mortality would be higher at lowervolume centers for CER, as well.…”

Section: Commentmentioning

confidence: 99%

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Complex Esophageal Reconstruction Procedures Have Acceptable Outcomes Compared With Routine Esophagectomy

Moore

Hooker

Molena

et al. 2016

The Annals of Thoracic Surgery

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Section: Commentmentioning

confidence: 99%

“…After esophagectomy, the rates of complications and length of stay (LOS) have been associated with numerous preoperative comorbidities, including smoking [13,14]. For all patients, the most frequent sources of morbidity are pneumothorax, pleural effusion, pneumonia, and respiratory failure [15].…”

mentioning

confidence: 99%

Complex Esophageal Reconstruction Procedures Have Acceptable Outcomes Compared With Routine Esophagectomy

Moore

Hooker

Molena

et al. 2016

The Annals of Thoracic Surgery

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“…A 2-surgeon approach has been previously reported in various areas of surgery including bilateral mastectomy, esophagectomy, bilateral anterior cruciate ligament reconstruction, and radical cystectomy. [10][11][12][13][14][15] The Guidelines for Standards in Cardiac Surgery, written by the American College of Surgeons, recommend that a minimum of 2 surgeons perform operative care in the operating room. 16 In recent years, some spine surgeons have advocated for a 2-surgeon approach for complex spinal surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative outcome data are reported in Table 4. Patients were discharged after a median of 5 days [interquartile range (IQR) [4][5][6][7][8][9][10][11][12][13][14][15]. A total of 55 (49%) patients presented with preoperative neurological deficits, as defined by the presence of a motor or a sensory deficit.…”

Section: Postoperative Outcomesmentioning

confidence: 99%

Two-Surgeon Multidisciplinary Approach to Pediatric Cervical Spinal Fusion: A Single-Institution Series and Review of the Literature

Lynch

Montgomery

Proctor

et al. 2023

Journal of Pediatric Orthopaedics

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Background: A collaborative 2-surgeon approach is becoming increasingly popular in surgery but is not widely used for pediatric cervical spine fusions. The goal of this study is to present a large single-institution experience with pediatric cervical spinal fusion using a multidisciplinary 2-surgeon team, including a neurosurgeon and an orthopedic surgeon. This team-based approach has not been previously reported in the pediatric cervical spine literature. Methods: A single-institution review of pediatric cervical spine instrumentation and fusion performed by a surgical team composed of neurosurgery and orthopedics during 2002-2020 was performed. Demographics, presenting symptoms and indications, surgical characteristics, and outcomes were recorded. Particular focus was given to describe the primary surgical responsibility of the orthopedic surgeon and the neurosurgeon. Results: A total of 112 patients (54% male) with an average age of 12.1 (range 2-26) years met the inclusion criteria. The most common indications for surgery were os odontoideum with instability (n = 21) and trauma (n = 18). Syndromes were present in 44 (39%) cases. Fifty-five (49%) patients presented with preoperative neurological deficits (26 motor, 12 sensory, and 17 combined deficits). At the time of the last clinical follow-up, 44 (80%) of these patients had stabilization or resolution of their neurological deficit. There was 1 new postoperative neural deficit (1%). The average time between surgery and successful radiologic arthrodesis was 13.2 ± 10.6 mo. A total of 15 (13%) patients experienced complications within 90 days of surgery (2 intraoperative, 6 during admission, and 7 after discharge). Conclusions: A multidisciplinary 2-surgeon approach to pediatric cervical spine instrumentation and fusion provides a safe treatment option for complex pediatric cervical cases. It is hoped that this study could provide a model for other pediatric spine groups interested in implementing a multi-specialty 2-surgeon team to perform complex pediatric cervical spine fusions. Level of Evidence: Level IV-case series.

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“…The 2003 Leapfrog Group recommended 13 esophagectomies/year as a minimum volume standard [31]. However, esophagectomies at mid-volume centers can also be safely performed, especially with a two-surgeon approach [32]. Hospital type may also be important where improved reoperation rates and mortality are seen when surgery is performed at University centers or institutions centralizing esophageal cancer care [33][34][35].…”

Section: The Optimal Surgeon/hospitalmentioning

confidence: 99%

Prevention and Management of Complications from Esophagectomy

Oxenberg¹

2018

Esophageal Cancer and Beyond

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While surgery plays a major role in the treatment and potential cure of esophageal cancer, esophagectomy continues to have a significant amount of morbidity compared to other surgical oncology procedures. Efforts to improve morbidity and mortality from esophagectomy include the Consensus Guidelines for Complications from Esophagectomies, Enhanced Recovery after Surgery protocols as well as others. Although we strive to improve morbidity and mortality after these surgeries, adverse events still occur. They affect not only patient quality of life and increase cost of care for esophageal cancer but also have a negative impact on overall cancer survival. This chapter reviews the prevention of adverse outcomes from esophagectomies as well as discusses the management of many complications that may occur more common to the operation.

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Esophagectomy outcomes at a mid-volume cancer center utilizing prospective multidisciplinary care and a 2-surgeon team approach

Cited by 12 publications

References 11 publications

Complex Esophageal Reconstruction Procedures Have Acceptable Outcomes Compared With Routine Esophagectomy

Complex Esophageal Reconstruction Procedures Have Acceptable Outcomes Compared With Routine Esophagectomy

Two-Surgeon Multidisciplinary Approach to Pediatric Cervical Spinal Fusion: A Single-Institution Series and Review of the Literature

Prevention and Management of Complications from Esophagectomy

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