Intrathoracic Robotic-Sewn Anastomosis During Ivor Lewis Esophagectomy for Cancer: Back to Basics?

Hüscher, C; Cobellis, Francesco; Lazzarin, Gianni

doi:10.1007/s11605-023-05616-w

Cited by 6 publications

(7 citation statements)

References 18 publications

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“…Huscher states that these outcomes are similar with those reported in the literature, but only references 1 study of 100 patients by van der Sluis to support the claim ( 79 , 80 ). No comparisons were made to a large series, open surgery or other minimally invasive techniques ( 79 ). To their credit, the authors also mention that the procedures were all performed after completing their training learning curve, but do not specify the number of cases that are required ( 79 ).…”

Section: Miesupporting

confidence: 70%

Section: Miementioning

confidence: 99%

“…Another paper recently published by Huscher and colleagues describes a case series of 40 patients who underwent Ivor Lewis with a robotic hand-sewn anastomosis ( 79 ). The authors report complications in 47% of patients, AL in 13%, and 2 in-hospital deaths with an average stay of 13.5 days ( 79 ). Huscher states that these outcomes are similar with those reported in the literature, but only references 1 study of 100 patients by van der Sluis to support the claim ( 79 , 80 ).…”

Section: Miementioning

confidence: 99%

“…The authors report complications in 47% of patients, AL in 13%, and 2 in-hospital deaths with an average stay of 13.5 days ( 79 ). Huscher states that these outcomes are similar with those reported in the literature, but only references 1 study of 100 patients by van der Sluis to support the claim ( 79 , 80 ). No comparisons were made to a large series, open surgery or other minimally invasive techniques ( 79 ).…”

Section: Miementioning

confidence: 99%

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A narrative review of anastomotic leak in the Ivor Lewis esophagectomy: expected, accepted, but preventable

Housman,

Lee,

Flores

2023

Transl Cancer Res

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Background and Objective Anastomotic leak (AL) remains a common and highly morbid complication after Ivor Lewis Esophagectomy. Leak is associated with increased morbidity, mortality, strictures and even cancer recurrence. Unfortunately, despite advances in surgical technique and perioperative care, the reported frequency of AL has remained largely unchanged. Methods A PubMed search for all English-language articles that discuss Ivor Lewis esophagectomy, AL, risk factors, and outcomes was conducted from 1901 to 2023 prioritizing research from randomized trials that evaluated outcomes from patients undergoing esophagectomy. Key Content and Findings This narrative review will discuss the prevailing literature on AL, risk factors and outcomes with a focus on its relationship to the Ivor Lewis esophagectomy (ILE). In particular, we emphasize that the gastric conduit, as commonly created for most esophagectomy procedures, is inherently vulnerable to ischemia. We will show trends in the literature that have contributed to the high rate of postoperative complications, with a focus on the AL. In addition, we propose that the traditional Ivor Lewis procedure itself is a risk factor for AL. We review a surgical alternative that increases blood supply of the conduit, and is associated with reduced leak, no strictures, and improved surgical outcomes. Conclusions Multiple factors contribute to AL after esophagectomy; including several current surgical practices. We believe that some of them, especially the commonly accepted approach to the gastric conduit, can be modified to optimize tissue perfusion. With further investigation, we may reduce the incidence of short and long-term anastomotic complications and improve surgical outcomes.

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Section: Miesupporting

confidence: 70%

Section: Miementioning

confidence: 99%

Section: Miementioning

confidence: 99%

Section: Miementioning

confidence: 99%

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A narrative review of anastomotic leak in the Ivor Lewis esophagectomy: expected, accepted, but preventable

Housman,

Lee,

Flores

2023

Transl Cancer Res

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“…Despite advances in minimally invasive surgical techniques, anastomotic fistula remains a serious complication, causing significant morbidity and mortality. The rate of anastomotic fistula after esophagectomy varies in the literature between 2 and 20%, being one of the most common surgical complications [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

The Use of Esophageal Stents in the Management of Postoperative Fistulas—Current Status, Clinical Outcomes and Perspectives—Review

Hoara

Achim

et al. 2023

Life

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Esophageal fistula remains one of the main postoperative complications, with the treatment often requiring the use of stents. This article reviews the updates on the use of endoscopic stents for the treatment of postoperative esophageal leakage in terms of indications, types of stents used, efficiency, specific complications and perspectives. Materials and Methods: We searched the PubMed and MEDLINE databases for the keywords postoperative esophageal anastomotic leak and postoperative esophageal anastomotic leak stent, and retrieved relevant papers published until December 2022. Results: The endoscopic discovery of the fistula is usually followed by the insertion of a fully covered esophageal stent. It has an efficiency of more than 60% in closing the fistula, and the failure is related to the delayed application of the method, a situation more suitable for endo vac therapy. The most common complication is migration, but life-threatening complications have also been described. The combination of the advantages of endoscopic stents and vacuum therapy is probably found in the emerging VACstent procedure. Conclusions: Although the competing approaches give promising results, this method has a well-defined place in the treatment of esophageal fistulas, and it is probably necessary to refine the indications for each individual procedure.

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Preserving vascular integrity during totally robotic sigmoidectomy: unleashing the power of vessel-sparing precision

Huscher,

Cobellis,

Lazzarin

2024

Langenbecks Arch Surg

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Intrathoracic Robotic-Sewn Anastomosis During Ivor Lewis Esophagectomy for Cancer: Back to Basics?

Cited by 6 publications

References 18 publications

A narrative review of anastomotic leak in the Ivor Lewis esophagectomy: expected, accepted, but preventable

A narrative review of anastomotic leak in the Ivor Lewis esophagectomy: expected, accepted, but preventable

The Use of Esophageal Stents in the Management of Postoperative Fistulas—Current Status, Clinical Outcomes and Perspectives—Review

Preserving vascular integrity during totally robotic sigmoidectomy: unleashing the power of vessel-sparing precision

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