Prospective randomized study of one- or two-layer anastomosis following oesophageal resection and cervical oesophagogastrostomy

Zieren, H. U.; Müller, M.; Pichlmaier, H.

doi:10.1002/bjs.1800800519

Cited by 87 publications

(49 citation statements)

References 10 publications

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“…In our study, more than half of the radiological leaks were asymptomatic. Several authors have reported similar observations [10][11][12] .…”

Section: Discussionsupporting

confidence: 68%

“…The patients were kept non per os until a second GS study, and then were allowed oral feeding even if the second GS still showed a contained leak and remained asymptomatic. Zieren et al [10] , Tilanus et al [11] and Lee et al [12] , in their series, also observed that radiological leaks remained asympto matic.…”

Section: Discussionmentioning

confidence: 72%

“…apparent leaks represented only a proportion of the total who had radiological anastomotic leaks [3,[10][11][12][13] .…”

mentioning

confidence: 99%

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Effectiveness of Screening Aqueous Contrast Swallow in Detecting Clinically Significant Anastomotic Leaks after Esophagectomy

et al. 2005

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Background: Aqueous contrast swallow study is recommended as a screening procedure for the evaluation of esophageal anastomotic integrity following esophagectomy. The aim of this study was to assess the accuracy of water-soluble contrast swallow screening as a predictor of clinically significant anastomotic leak in patients with esophagectomy. Patients and Methods: The records of 505 consecutive patients undergoing esophagectomy in Mayo Clinic from January 1991 through December 1995 were retrospectively reviewed. 464 (92%) pa tients had water-soluble contrast swallows performed in the early postoperative period (median postoperative day 7, range 4–11 days). Results: A total of 39 radiological leaks were obtained but only 17 of these had clinical signs of anastomotic leakage. Furthermore, 25 patients who had normal swallow study developed a clinical anastomotic leak. There were therefore 22 (4.7%) false positive and 25 (5.4%) false negative results giving values for the specificity, sensitivity and false negative error rate of the radiological examination of 94.7, 40.4, and 59.5% respectively. Aspiration of the contrast agent was noted on fluoroscopy in 30 (6.5%) patients. Only 2 (0.4%) patients developed aqueous contrast agent-caused aspiration pneumonia. There was no procedure-related mortality. Conclusion: While radiological assessment of esophageal anastomoses in the early postoperative period using aqueous contrast agents appears to be a relatively safe procedure, the poor sensitivity and high false negative error rate of this technique, when performed on postoperative day 7 and in a series with clinical anastomotic leak rate of 9%, is insufficient for it to be worthwhile as a screening procedure.

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“…In our study, more than half of the radiological leaks were asymptomatic. Several authors have reported similar observations [10][11][12] .…”

Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 72%

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Effectiveness of Screening Aqueous Contrast Swallow in Detecting Clinically Significant Anastomotic Leaks after Esophagectomy

et al. 2005

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“…Zieren and co-workers 210 Leak defined as any radiographically demonstrable extravasation of water-soluble medium at the site of anastomosis on day 7 postoperatively.…”

Section: Obertop and Bosschamentioning

confidence: 99%

The measurement and monitoring of surgical adverse events

Bruce

Russell

Mollison

et al. 2001

Health Technol Assess

298

209

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK.We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTAThe measurement and monitoring of surgical adverse events NHS R&D HTA ProgrammeT he NHS R&D Health Technology Assessment (HTA) Programme was set up in 1993 to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS.Initially, six HTA panels (pharmaceuticals, acute sector, primary and community care, diagnostics and imaging, population screening, methodology) helped to set the research priorities for the HTA Programme. However, during the past few years there have been a number of changes in and around NHS R&D, such as the establishment of the National Institute for Clinical Excellence (NICE) and the creation of three new research programmes: Service Delivery and Organisation (SDO); New and Emerging Applications of Technology (NEAT); and the Methodology Programme.Although the National Coordinating Centre for Health Technology Assessment (NCCHTA) commissions research on behalf of the Methodology Programme, it is the Methodology Group that now considers and advises the Methodology Programme Director on the best research projects to pursue.The research reported in this monograph was funded as project number 97/16/04.The views expressed in this publication are those of the authors and not necessarily those of the Methodology Programme, HTA Programme or the Department of Health. The editors wish to emphasise that funding and publication of this research by the NHS should not be taken as implicit supp...

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“…mentioned techniques, most recent and even randomized trials have shown that there is really no big difference [1,2,14,15].…”

Section: Drainagc O F Cervical Esophagogastrostomymentioning

confidence: 99%

Drainage of Cervical Esophagogastrostomy: Essential or Dangerous?

et al. 1997

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Leakage from a cervical esophagogastric anastomosis still accounts for major morbidity and mortality after subtotal esophageal resection. Its prevalence might adversely be affected by drainage of the anastomosis. Therefore we conducted a prospective randomized trial on 60 consecutive patients after subtotal esophagectomy and cervical esophagogastrostomy. The patients were assigned to either a drainage (n = 29) or a non-drainage group (n = 31). Suture-line disruption was more common in the non-drainage (n = 6) than in the drainage group (n = 3), and other complications were also more frequent in the non-drainage than in the drainage group. We did not note any adverse effects of drainage itself. Taking this small collective into account, we nevertheless recommend drainage for cervical esophagogastrostomy because it is simple, free of complications and seems to have no major impact on the incidence of anastomotic disruption.

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Prospective randomized study of one- or two-layer anastomosis following oesophageal resection and cervical oesophagogastrostomy

Cited by 87 publications

References 10 publications

Effectiveness of Screening Aqueous Contrast Swallow in Detecting Clinically Significant Anastomotic Leaks after Esophagectomy

Effectiveness of Screening Aqueous Contrast Swallow in Detecting Clinically Significant Anastomotic Leaks after Esophagectomy

The measurement and monitoring of surgical adverse events

Drainage of Cervical Esophagogastrostomy: Essential or Dangerous?

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