Reporting of Short-Term Clinical Outcomes After Esophagectomy

Blencowe, Natalie S; Strong, Sean; McNair, Angus G K; Brookes, Sara; Crosby, Tom; Griffin, S. M.; Blazeby, Jane

doi:10.1097/sla.0b013e3182480a6a

Cited by 263 publications

(208 citation statements)

References 65 publications

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“…Because neoplastic disease progression in humans appears to be influenced predominantly by severe, as opposed to any septic, complication, selecting an experimental model that reproduces these features was considered imperative. CLP closely approximates the severe septic complications that can occur after a number of gastrointestinal surgeries, including colorectal, gastric, and esophageal oncologic resections (13,20,56). By definition, CLP results in the rapid onset of polymicrobial sepsis with endogenous flora.…”

Section: Figurementioning

confidence: 99%

Neutrophil extracellular traps sequester circulating tumor cells and promote metastasis

Cools-Lartigue¹,

Spicer²,

McDonald³

et al. 2013

J. Clin. Invest.

1,118

1,025

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The majority of patients with cancer undergo at least one surgical procedure as part of their treatment. Severe postsurgical infection is associated with adverse oncologic outcomes; however, the mechanisms underlying this phenomenon are unclear. Emerging evidence suggests that neutrophils, which function as the first line of defense during infections, facilitate cancer progression. Neutrophil extracellular traps (NETs) are extracellular neutrophil-derived DNA webs released in response to inflammatory cues that trap and kill invading pathogens. The role of NETs in cancer progression is entirely unknown. We report that circulating tumor cells become trapped within NETs in vitro under static and dynamic conditions. In a murine model of infection using cecal ligation and puncture, we demonstrated microvascular NET deposition and consequent trapping of circulating lung carcinoma cells within DNA webs. NET trapping was associated with increased formation of hepatic micrometastases at 48 hours and gross metastatic disease burden at 2 weeks following tumor cell injection. These effects were abrogated by NET inhibition with DNAse or a neutrophil elastase inhibitor. These findings implicate NETs in the process of cancer metastasis in the context of systemic infection and identify NETs as potential therapeutic targets. IntroductionCancer remains a devastating cause of mortality worldwide, with the majority of patients dying as a result of metastasis (1-3). Currently, locoregional control in the form of complete oncologic resection remains an essential curative modality for nearly all solid tumors and provides improved overall and disease-free survival (2, 4,5). Control of distant recurrence is predominantly achieved through systemic chemotherapy, with variable results (6-8). However, standard oncologic interventions can have negative consequences. First, manipulation of the primary tumor during surgery is associated with increased numbers of circulating tumor cells (CTCs) (9). Second, infectious complications occur as a result of cancer progression itself, such as bowel obstruction or pneumonia (10, 11), and due to complications of standard cancer treatments, such as chemotherapy and surgery (12)(13)(14).Postsurgical infections occur with alarming frequency, with an incidence approaching 40% in some series (15)(16)(17). Given that the majority of the nearly 2 million patients diagnosed with cancer in 2012 in the United States alone underwent at least one surgical procedure, the tremendous potential burden of infection becomes apparent (18). One disturbing feature of severe infectious complications in patients with cancer is their association with adverse oncologic outcomes independent of the morbidity associated with the infectious insult (14,(19)(20)(21). This phenomenon has been observed across a broad range of malignancies, including lung, esophageal, breast, ovarian, and colorectal cancer, whereby severe postoperative infectious complications, such as pneumonia, peritonitis, and sepsis, are significantly associated wit...

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Section: Figurementioning

confidence: 99%

Neutrophil extracellular traps sequester circulating tumor cells and promote metastasis

Cools-Lartigue¹,

Spicer²,

McDonald³

et al. 2013

J. Clin. Invest.

1,118

1,025

View full text Add to dashboard Cite

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“…The complications reported for this type of surgery are pneumonia in 2 -39 %, anastomotic leakage in 0 -35 % and recurrent paresis in 0 -31 % (15). Post-operative mortality also varies from one study to the next, and ranges from 0 -15 % (15,16).…”

Section: Resultsmentioning

confidence: 99%

“…Comparing the incidence of post-operative complications and mortality after oesophageal resection in different studies is challenging because standardised complication definitions and grades are not used (15,16).…”

Section: Discussionmentioning

confidence: 99%

Reseksjon for oesophaguscancer – komplikasjoner og overlevelse

Grøtting¹,

Løberg²,

Johannessen³

et al. 2016

Tidsskriftet

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MAIN POINTSOutcomes for hybrid oesophageal section were no post-operative mortality, a low proportion of serious complications and good five-year survival There is a growing tendency for minimally invasive procedures in the surgical treatment of oesophageal cancer BACKGROUND Surgery is regarded as necessary for achieving a cure with oesophageal cancer. Minimally invasive procedures are increasingly being employed in oesophageal resection, with the aim of achieving fewer complications than with open surgery. The purpose of this study was to investigate post-operative complications, mortality and long-term survival after hybrid oesophageal resection by means of laparoscopy and thoracotomy.

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“…Cervical anastomotic complications of oesophagectomy have been the problem of thoracic surgeons for a long time. Many different hand-suture techniques, such as monolayer or multilayer suture, nonabsorbable or absorbable suture lines and intermittent or continuous suture, have been used, but a high incidence rate of anastomotic leakage reaching 10 to 27 % is still observed [13][14][15]. In this study, seven cases showed anastomotic leakage, but all these cases were cured after conservative treatment, and no operative death occurred [16].…”

Section: Discussionmentioning

confidence: 99%

Application of Oesophagogastric Cervical Mechanical Anastomosis in Oesophagectomy for Cancer

2014

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We aimed to explore the safety and the feasibility of the application of digestive tract-specific circular anastomats in oesophagogastric cervical anastomosis after oesophagectomy for cancer. We retrospectively analysed the clinical data of 241 patients undergoing oesophagogastric cervical anastomosis using disposable circular staplings after oesophagectomy in the People's Hospital of Henan Province, from August 2009 to July 2012. A total of 240 patients were anastomosed successfully. One patient had a partially torn oesophagus and underwent repair because the wrong stapler size was used. No operative death occurred. Seven patients (2.9 %) had postoperative cervical anastomotic leakage but recovered after shortterm conservative treatment, and three patients had obvious gastro-oesophageal reflux after eating. No intrathoracic anastomotic leakage or other anastomotic instrument-related complications occurred. During a median follow-up period of 13.8 months, no anastomotic stricture was found in each patient. The application of oesophagogastric cervical anastomosis using circular anastomat after oesophagectomy for cancer was safe and feasible.

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Reporting of Short-Term Clinical Outcomes After Esophagectomy

Cited by 263 publications

References 65 publications

Neutrophil extracellular traps sequester circulating tumor cells and promote metastasis

Neutrophil extracellular traps sequester circulating tumor cells and promote metastasis

Reseksjon for oesophaguscancer – komplikasjoner og overlevelse

Application of Oesophagogastric Cervical Mechanical Anastomosis in Oesophagectomy for Cancer

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