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1. Textbook outcome following oesophagectomy for cancer: international cohort study

Author

Kamarajah, S. K., Evans, R. P. T., Nepogodiev, D., Hodson, J., Bundred, J. R., Gockel, I., Gossage, J. A., Isik, A., Kidane, B., Mahendran, H. A., Negoi, I., Okonta, K. E., Sayyed, R., van Hillegersberg, R., Vohra, R. S., Wijnhoven, B. P. L., Singh, P., Griffiths, E. A., Alderson, D., Bundred, J., Gossage, J., Jefferies, B., Mckay, S., Mohamed, I., Siaw-Acheampong, K., Vohra, R., Wanigasooriya, K., Whitehouse, T., Gjata, A., Moreno, J. I., Takeda, F. R., Guevara Castro, R., Harustiak, T., Bekele, A., Kechagias, A., Kennedy, A., Da Roit, A., Bagajevas, A., Azagra, J. S., Mej??a-Fern??ndez, L., El Kafsi, J., Sayyed, R. H., Sousa M, M., Sampaio, A. S., Blanco, R., Wallner, B., Schneider, P. M., Hsu, P. K., Gananadha, S., Wills, V., Devadas, M., Duong, C., Talbot, M., Hii, M. W., Jacobs, R., Andreollo, N. A., Johnston, B., Darling, G., Isaza-Restrepo, A., Rosero, G., Arias-Am??zquita, F., Raptis, D., Gaedcke, J., Reim, D., Izbicki, J., Egberts, J. H., Dikinis, S., Kjaer, D. W., Larsen, M. H., Achiam, M. P., Saarnio, J., Theodorou, D., Liakakos, T., Korkolis, D. P., Robb, W. B., Collins, C., Murphy, T., Reynolds, J., Tonini, V., Migliore, M., Bonavina, L., Valmasoni, M., Bardini, R., Weindelmayer, J., Terashima, M., White, R. E., Alghunaim, E., Elhadi, M., Leon-Takahashi, A. M., Medina-Franco, H., Lau, P. C., Heisterkamp, J., Rosman, C., Beban, G., Babor, R., Gordon, A., Rossaak, J. I., Pal, K. M. I., Qureshi, A. U., Naqi, S. A., Syed, A. A., Barbosa, J., Vicente, C. S., Leite, J., Freire, J., Casaca, R., Costa, R. C. T., Scurtu, R. R., Mogoanta, S. S., Bolca, C., Constantinoiu, S., Sekhniaidze, D., Bjelovi??, M., J. B. Y., So, Ga??evski, G., Loureiro, C., Pera, M., Bianchi, A., Moreno Gij??n, M., Fern??ndez, J. Mart??n., Trugeda Carrera, M. S., Vallve-Bernal, M., C??tores Pascual, M. A., Elmahi, S., Halldestam, I., Hedberg, J., M??nig, S., Gutknecht, S., Tez, M., Guner, A., Tirnaksiz, M. B., Colak, E., Sevin??, B., Hindmarsh, A., Khan, I., Khoo, D., Byrom, R., Gokhale, J., Wilkerson, P., Jain, P., Chan, D., Robertson, K., Iftikhar, S., Skipworth, R., Forshaw, M., Higgs, S., Nijjar, R., Viswanath, Y. K. S., Turner, P., Dexter, S., Boddy, A., Allum, W. H., Oglesby, S., Cheong, E., Beardsmore, D., Maynard, N., Berrisford, R., Mercer, S., Puig, S., Melhado, R., Kelty, C., Underwood, T., Dawas, K., Lewis, W., Bryce, G., Thomas, M., Arndt, A. T., Palazzo, F., Meguid, R. A., Fergusson, J., Beenen, E., Mosse, C., Salim, J., Cheah, S., Wright, T., Cerdeira, M. P., Mcquillan, P., Richardson, M., Liem, H., Spillane, J., Yacob, M., Albadawi, F., Thorpe, T., Dingle, A., Cabalag, C., Loi, K., Fisher, O. M., Ward, S., Read, M., Johnson, M., Bassari, R., Bui, H., Cecconello, I., Sallum, R. A. A., da Rocha, J. R. M., Lopes, L. R., Tercioti Jr, V., Coelho, J. D. S., Ferrer, J. A. P., Buduhan, G., Tan, L., Srinathan, S., Shea, P., Yeung, J., Allison, F., Carroll, P., Vargas-Barato, F., Gonzalez, F., Ortega, J., Nino-Torres, L., Beltr??n-Garc??a, T. C., Castilla, L., Pineda, M., Bastidas, A., G??mez-Mayorga, J., Cort??s, N., Cetares, C., Caceres, S., Duarte, S., Pazdro, A., Snajdauf, M., Faltova, H., Sevcikova, M., Mortensen, P. B., Katballe, N., Ingemann, T., Morten, B., Kruhlikava, I., Ainswort, A. P., Stilling, N. M., Eckardt, J., Holm, J., Thorsteinsson, M., Siemsen, M., Brandt, B., Nega, B., Teferra, E., Tizazu, A., Kauppila, J. H., Koivukangas, V., Meril??inen, S., Gruetzmann, R., Krautz, C., Weber, G., Golcher, H., Emons, G., Azizian, A., Ebeling, M., Niebisch, S., Kreuser, N., Albanese, G., Hesse, J., Volovnik, L., Boecher, U., Reeh, M., Triantafyllou, S., Schizas, D., Michalinos, A., Balli, E., Mpoura, M., Charalabopoulos, A., Manatakis, D. K., Balalis, D., Bolger, J., Baban, C., Mastrosimone, A., Mcanena, O., Quinn, A., S??illeabh??in, C. B., Hennessy, M. M., Ivanovski, I., Khizer, H., Ravi, N., Donlon, N., Cervellera, M., Vaccari, S., Bianchini, S., Asti, E., Bernardi, D., Merigliano, S., Provenzano, L., Scarpa, M., Saadeh, L., Salmaso, B., De Manzoni, G., Giacopuzzi, S., La Mendola, R., De Pasqual, C. A., Tsubosa, Y., Niihara, M., Irino, T., Makuuchi, R., Ishii K, K., Mwachiro, M., Fekadu, A., Odera, A., Mwachiro, E., Alshehab, D., Ahmed, H. A., Shebani, A. O., Elhadi, A., Elnagar, F. A., Elnagar, H. F., Makkai-Popa, S. T., Wong, L. F., Tan, Y. R., Thannimalai, S., C. A., Ho, Pang, W. S., Tan, J. H., Basave, H. N. L., Cort??s-Gonz??lez, R., Lagarde, S. M., van Lanschot, J. J. B., Cords, C., Jansen, W. A., Martijnse, I., Matthijsen, R., Bouwense, S., Klarenbeek, B., Verstegen, M., van Workum, F., Ruurda, J. P., van der Sluis, P. C., de Maat, M., Evenett, N., Johnston, P., Patel, R., Maccormick, A., Smith, B., Ekwunife, C., Memon, A. H., Shaikh, K., Wajid, A., Khalil, N., Haris, M., Mirza, Z. U., Qudus, S. B. A., Sarwar, M. Z., Shehzadi, A., Raza, A., Jhanzaib, M. H., Farmanali, J., Zakir, Z., Shakeel, O., Nasir, I., Khattak, S., Baig, M., Noor, M. A., Ahmed, H. H., Naeem, A., Pinho, A. C., da Silva, R., Bernardes, A., Campos, J. C., Matos, H., Braga, T., Monteiro, C., Ramos, P., Cabral, F., Gomes, M. P., Martins, P. C., Correia, A. M., Videira, J. F., Ciuce, C., Drasovean, R., Apostu, R., Paitici, S., Racu, A. E., Obleaga, C. V., Beuran, M., Stoica, B., Ciubotaru, C., Negoita, V., Cordos, I., Birla, R. D., Predescu, D., Hoara, P. A., Tomsa, R., Shneider, V., Agasiev, M., Ganjara, I., Gunji??, D., Veselinovi??, M., Babi??, T., Chin, T. S., Shabbir, A., Kim, G., Crnjac, A., Samo, H., D??ez del Val, I., Leturio, S., Ram??n, J. M., Dal Cero, M., Rif??, S., Rico, M., Pagan Pomar, A., Martinez Corcoles, J. A., Rodicio Miravalles, J. L., Pais, S. A., Turienzo, S. A., Alvarez, L. S., Campos, P. V., Rendo, A. G., Garc??a, S. S., Santos, E. P. G., Mart??nez, E. T., Fern??ndez D??az, M. J., lvarez, C. Magad??n., Mart??n, V. Concepci??n., D??az L??pez, C., Rosat Rodrigo, A., P??rez S??nchez, L. E., Cuadrado, M. Bail??n., Tinoco Carrasco, C., Choolani Bhojwani, E., S??nchez, D. P., Ahmed, M. E., Dzhendov, T., Lindberg, F., Ruteg??rd, M., Sundbom, M., Mickael, C., Colucci, N., Schnider, A., Er, S., Kurnaz, E., Turkyilmaz, S., Turkyilmaz, A., Yildirim, R., Baki, B. E., Akkapulu, N., Karahan, O., Damburaci, N., Hardwick, R., Safranek, P., Sujendran, V., Bennett, J., Afzal, Z., Shrotri, M., Chan, B., Exarchou, K., Gilbert, T., Amalesh, T., Mukherjee, D., Mukherjee, S., Wiggins, T. H., Kennedy, R., Mccain, S., Harris, A., Dobson, G., Davies, N., Wilson, I., Mayo, D., Bennett, D., Young, R., Manby, P., Blencowe, N., Schiller, M., Byrne, B., Mitton, D., Wong, V., Elshaer, A., Cowen, M., Menon, V., Tan, L. C., Mclaughlin, E., Koshy, R., Sharp, C., Brewer, H., Das, N., Cox, M., Al Khyatt, W., Worku, D., Iqbal, R., Walls, L., Mcgregor, R., Fullarton, G., Macdonald, A., Mackay, C., Craig, C., Dwerryhouse, S., Hornby, S., Jaunoo, S., Wadley, M., Baker, C., Saad, M., Kelly, M., Davies, A., Di Maggio, F., Mistry, P., Singhal, R., Tucker, O., Kapoulas, S., Powell-Brett, S., Davis, P., Bromley, G., Watson, L., Verma, R., Ward, J., Shetty, V., Ball, C., Pursnani, K., Sarela, A., Sue Ling, H., Mehta, S., Hayden, J., To, N., Palser, T., Hunter, D., Supramaniam, K., Butt, Z., Ahmed, A., Kumar, S., Chaudry, A., Moussa, O., Kordzadeh, A., Lorenzi, B., Wilson, M., Patil, P., Noaman, I., Bouras, G., Evans, R., Singh, M., Warrilow, H., Ahmad, A., Tewari, N., Yanni, F., Couch, J., Theophilidou, E., Reilly, J. J., van Boxel, G., Akbari, K., Zanotti, D., Sanders, G., Wheatley, T., Ariyarathenam, A., Reece-Smith, A., Humphreys, L., Choh, C., Carter, N., Knight, B., Pucher, P., Athanasiou, A., Tan, B., Abdulrahman, M., Vickers, J., Akhtar, K., Chaparala, R., Brown, R., Alasmar, M. M. A., Ackroyd, R., Patel, K., Tamhankar, A., Wyman, A., Walker, R., Grace, B., Abbassi, N., Slim, N., Ioannidi, L., Blackshaw, G., Havard, T., Escofet, X., Powell, A., Owera, A., Rashid, F., Jambulingam, P., Padickakudi, J., Ben-Younes, H., Mccormack, K., Makey, I. A., Karush, M. K., Seder, C. W., Liptay, M. J., Chmielewski, G., Rosato, E. L., Berger, A. C., Zheng, R., Okolo, E., Singh, A., Scott, C. D., Weyant, M. J., Mitchell, J. D., and Surgery

Subjects
Male, Textbook, MINIMALLY INVASIVE ESOPHAGECTOMY, Minimally Invasive Surgical Procedures/methods, Esophageal Neoplasms, SURGERY, Anastomosis, LYMPH-NODE RETRIEVAL, Anastomosis, Surgical, education, Anastomosis, Surgical/adverse effects, Esophageal Neoplasms/pathology, Esophagectomy/methods, Cohort Studies, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], Treatment Outcome, SDG 3 - Good Health and Well-being, Humans, Minimally Invasive Surgical Procedures, Esophagectomy, Surgical, esophagectomy, Surgery, Textbook, esophagectomy, esophageal cancer, esophageal cancer
Abstract

Background Textbook outcome has been proposed as a tool for the assessment of oncological surgical care. However, an international assessment in patients undergoing oesophagectomy for oesophageal cancer has not been reported. This study aimed to assess textbook outcome in an international setting. Methods Patients undergoing curative resection for oesophageal cancer were identified from the international Oesophagogastric Anastomosis Audit (OGAA) from April 2018 to December 2018. Textbook outcome was defined as the percentage of patients who underwent a complete tumour resection with at least 15 lymph nodes in the resected specimen and an uneventful postoperative course, without hospital readmission. A multivariable binary logistic regression model was used to identify factors independently associated with textbook outcome, and results are presented as odds ratio (OR) and 95 per cent confidence intervals (95 per cent c.i.). Results Of 2159 patients with oesophageal cancer, 39.7 per cent achieved a textbook outcome. The outcome parameter ‘no major postoperative complication’ had the greatest negative impact on a textbook outcome for patients with oesophageal cancer, compared to other textbook outcome parameters. Multivariable analysis identified male gender and increasing Charlson comorbidity index with a significantly lower likelihood of textbook outcome. Presence of 24-hour on-call rota for oesophageal surgeons (OR 2.05, 95 per cent c.i. 1.30 to 3.22; P = 0.002) and radiology (OR 1.54, 95 per cent c.i. 1.05 to 2.24; P = 0.027), total minimally invasive oesophagectomies (OR 1.63, 95 per cent c.i. 1.27 to 2.08; P < 0.001), and chest anastomosis above azygous (OR 2.17, 95 per cent c.i. 1.58 to 2.98; P < 0.001) were independently associated with a significantly increased likelihood of textbook outcome. Conclusion Textbook outcome is achieved in less than 40 per cent of patients having oesophagectomy for cancer. Improvements in centralization, hospital resources, access to minimal access surgery, and adoption of newer techniques for improving lymph node yield could improve textbook outcome.

Published
2022

2. Mortality from esophagectomy for esophageal cancer across low, middle, and high-income countries: An international cohort study

Author

Kamarajah, S. K. Nepogodiev, D. Bekele, A. Cecconello, I. and Evans, R. P. T. Guner, A. Gossage, J. A. Harustiak, T. and Hodson, J. Isik, A. Kidane, B. Leon-Takahashi, A. M. and Mahendran, H. A. Negoi, I. Okonta, K. E. Rosero, G. and Sayyed, R. H. Singh, P. Takeda, F. R. van Hillegersberg, R. and Vohra, R. S. White, R. E. Griffiths, E. A. Alderson, D. and Bundred, J. Evans, R. P. T. Gossage, J. Griffiths, E. A. and Jefferies, B. Kamarajah, S. K. McKay, S. Mohamed, I. and Nepogodiev, D. Siaw-Acheampong, K. Singh, P. van Hillegersberg, R. Vohra, R. Wanigasooriya, K. Whitehouse, T. and Gjata, A. Moreno, J. I. Takeda, F. R. Kidane, B. and Guevara, Castro R. Harustiak, T. Bekele, A. Kechagias, A. and Gockel, I. Kennedy, A. Da Roit, A. Bagajevas, A. and Azagra, J. S. Mahendran, H. A. Mejia-Fernandez, L. and Wijnhoven, B. P. L. El Kafsi, J. Sayyed, R. H. Sousa, M. and Sampaio, A. S. Negoi, I. Blanco, R. Wallner, B. and Schneider, P. M. Hsu, P. K. Isik, A. Gananadha, S. and Wills, V. Devadas, M. Duong, C. Talbot, M. Hii, M. W. and Jacobs, R. Andreollo, N. A. Johnston, B. Darling, G. and Isaza-Restrepo, A. Rosero, G. Arias-Amezquita, F. Raptis, D. and Gaedcke, J. Reim, D. Izbicki, J. Egberts, J. H. and Dikinis, S. Kjaer, D. W. Larsen, M. H. Achiam, M. P. and Saarnio, J. Theodorou, D. Liakakos, T. Korkolis, D. P. and Robb, W. B. Collins, C. Murphy, T. Reynolds, J. Tonini, V. Migliore, M. Bonavina, L. Valmasoni, M. Bardini, R. and Weindelmayer, J. Terashima, M. White, R. E. Alghunaim, E. Elhadi, M. Leon-Takahashi, A. M. Medina-Franco, H. and Lau, P. C. Okonta, K. E. Heisterkamp, J. Rosman, C. van Hillegersberg, R. Beban, G. Babor, R. Gordon, A. and Rossaak, J. I. Pal, K. M. I. Qureshi, A. U. Naqi, S. A. and Syed, A. A. Barbosa, J. Vicente, C. S. Leite, J. Freire, J. Casaca, R. Costa, R. C. T. Scurtu, R. R. Mogoanta, S. S. Bolca, C. Constantinoiu, S. Sekhniaidze, D. Bjelovic, M. So, J. B. Y. Gacevski, G. Loureiro, C. Pera, M. and Bianchi, A. Moreno, Gijon M. Martin Fernandez, J. Carrera, M. S. Trugeda Vallve-Bernal, M. Pascual, M. A. Citores and Elmahi, S. Halldestam, I. Hedberg, J. Monig, S. and Gutknecht, S. Tez, M. Guner, A. Tirnaksiz, M. B. Colak, E. Sevinc, B. Hindmarsh, A. Khan, I. Khoo, D. Byrom, R. Gokhale, J. Wilkerson, P. Jain, P. Chan, D. and Robertson, K. Iftikhar, S. Skipworth, R. Forshaw, M. and Higgs, S. Gossage, J. Nijjar, R. Viswanath, Y. K. S. and Turner, P. Dexter, S. Boddy, A. Allum, W. H. Oglesby, S. and Cheong, E. Beardsmore, D. Vohra, R. Maynard, N. and Berrisford, R. Mercer, S. Puigt, S. Melhadot, R. Kelty, C. Underwood, T. Dawas, K. Lewis, W. Al-Bahrani, A. and Bryce, G. Thomas, M. Arndt, A. T. Palazzo, F. Meguid, R. A. Fergusson, J. Beenen, E. Mosse, C. Salim, J. and Cheah, S. Wright, T. Cerdeira, M. P. McQuillan, P. and Richardson, M. Liem, H. Spillane, J. Yacob, M. Albadawi, F. Thorpe, T. Dingle, A. Cabalag, C. Loi, K. Fisher, O. M. Ward, S. Read, M. Johnson, M. Bassari, R. Bui, H. Cecconello, I. Sallum, R. A. A. da Rocha, J. R. M. and Lopes, L. R. Tercioti, Jr., V. Coelho, J. D. Ferrer, J. A. P. Buduhan, G. Tan, L. Srinathan, S. Shea, P. Yeung, J. Allison, F. Carroll, P. Vargas-Barato, F. Gonzalez, F. Ortega, J. Nino-Torres, L. Beltran-Garcia, T. C. and Castilla, L. Pineda, M. Bastidas, A. Gomez-Mayorga, J. and Cortes, N. Cetares, C. Caceres, S. Duarte, S. Pazdro, A. and Snajdauf, M. Faltova, H. Sevcikova, M. Mortensen, P. B. and Katballe, N. Ingemann, T. Morten, B. Kruhlikava, I. and Ainswort, A. P. Stilling, N. M. Eckardt, J. Holm, J. and Thorsteinsson, M. Siemsen, M. Brandt, B. Nega, B. and Teferra, E. Tizazu, A. Kauppila, J. H. Koivukangas, V. and Merilainen, S. Gruetzmann, R. Krautz, C. Weber, G. and Golcher, H. Emons, G. Azizian, A. Ebeling, M. Niebisch, S. Kreuser, N. Albanese, G. Hesse, J. Volovnik, L. and Boecher, U. Reeh, M. Triantafyllou, S. Schizas, D. and Michalinos, A. Mpali, E. Mpoura, M. Charalabopoulos, A. and Manatakis, D. K. Balalis, D. Bolger, J. Baban, C. and Mastrosimone, A. McAnena, O. Quinn, A. Suilleabhain, C. B. O. Hennessy, M. M. Ivanovski, I. Khizer, H. Ravi, N. and Donlon, N. Cervellera, M. Vaccari, S. Bianchini, S. and Sartarelli, L. Asti, E. Bernardi, D. Merigliano, S. and Provenzano, L. Scarpa, M. Saadeh, L. Salmaso, B. De Manzoni, G. Giacopuzzi, S. La Mendola, R. De Pasqual, C. A. and Tsubosa, Y. Niihara, M. Irino, T. Makuuchi, R. and Ishii, K. Mwachiro, M. Fekadu, A. Odera, A. Mwachiro, E. and AlShehab, D. Ahmed, H. A. Shebani, A. O. Elhadi, A. and Elnagar, F. A. Elnagar, H. F. Makkai-Popa, S. T. Wong, L. F. and Tan, Y. R. Thannimalai, S. Ho, C. A. Pang, W. S. and Tan, J. H. Basave, H. N. L. Cortes-Gonzalez, R. Lagarde, S. M. van Lanschot, J. J. B. Cords, C. Jansen, W. A. and Martijnse, I. Matthijsen, R. Bouwense, S. Klarenbeek, B. and Verstegen, M. van Workum, F. Ruurda, J. P. van der Sluis, P. C. de Maat, M. Evenett, N. Johnston, P. Patel, R. and MacCormick, A. Young, M. Smith, B. Ekwunife, C. Memon, A. H. Shaikh, K. Wajid, A. Khalil, N. Haris, M. and Mirza, Z. U. Qudus, S. B. A. Sarwar, M. Z. Shehzadi, A. and Raza, A. Jhanzaib, M. H. Farmanali, J. Zakir, Z. and Shakeel, O. Nasir, I. Khattak, S. Baig, M. Noor, M. A. and Ahmed, H. H. Naeem, A. Pinho, A. C. da Silva, R. and Bernardes, A. Campos, J. C. Matos, H. Braga, T. and Monteiro, C. Ramos, P. Cabral, F. Gomes, M. P. Martins, P. C. Correia, A. M. Videira, J. F. Ciuce, C. Drasovean, R. Apostu, R. Ciuce, C. Paitici, S. Racu, A. E. and Obleaga, C. V. Beuran, M. Stoica, B. Ciubotaru, C. and Negoita, V. Cordos, I. Birla, R. D. Predescu, D. Hoara, P. A. Tomsa, R. Shneider, V. Agasiev, M. Ganjara, I. and Gunjic, D. Veselinovic, M. Babic, T. Chin, T. S. and Shabbir, A. Kim, G. Crnjac, A. Samo, H. Del Val, I. Diez and Leturio, S. Ramon, J. M. Dal Cero, M. Rifa, S. Rico, M. Pomar, A. Pagan Corcoles, J. A. Martinez Miravalles, J. L. Rodicio Pais, S. A. Turienzo, S. A. Alvarezt, L. S. and Alvarez, L. S. Campos, P. V. Rendo, A. G. Garcia, S. S. and Santos, E. P. G. Martinez, E. T. Fernandez, Diaz Mj Magadan, Alvarez C. Concepcion, Martin V. Diaz, Lopez C. Rosat, Rodrigo A. Perez, Sanchez L. E. Bailon, Cuadrado M. Tinoco, Carrasco C. Bhojwani, E. Choolani Sanchez, D. P. Ahmed, M. E. Dzhendov, T. Lindberg, F. Rutegard, M. Sundbom, M. and Mickael, C. Colucci, N. Schnider, A. Er, S. Kurnaz, E. Turkyilmaz, S. Turkyilmaz, A. Yildirim, R. Baki, B. E. Akkapulu, N. Karahan, O. Damburaci, N. Hardwickt, R. and Safranek, P. Sujendran, V. Bennett, J. Afzal, Z. and Shrotri, M. Chan, B. Exarchou, K. Gilbert, T. Amalesh, T. Mukherjee, D. Mukherjee, S. Wiggins, T. H. Kennedy, R. McCain, S. Harris, A. Dobson, G. Davies, N. and Wilson, I. Mayo, D. Bennett, D. Young, R. Manby, P. and Blencowe, N. Schiller, M. Byrne, B. Mitton, D. Wong, V. and Elshaer, A. Cowen, M. Menon, V. Tan, L. C. and McLaughlin, E. Koshy, R. Sharp, C. Brewer, H. Das, N. and Cox, M. Al Khyatt, W. Worku, D. Iqbal, R. Walls, L. and McGregor, R. Fullarton, G. Macdonald, A. MacKay, C. and Craig, C. Dwerryhouse, S. Hornby, S. Jaunoo, S. Wadley, M. Baker, C. Saad, M. Kelly, M. Davies, A. Di Maggio, F. McKay, S. Mistry, P. Singhal, R. Tucker, O. and Kapoulas, S. Powell-Brett, S. Davis, P. Bromley, G. and Watson, L. Verma, R. Ward, J. Shetty, V. Ball, C. and Pursnani, K. Sarela, A. Sue, Ling H. Mehta, S. Hayden, J. To, N. Palser, T. Hunter, D. Supramaniam, K. and Butt, Z. Ahmed, A. Kumar, S. Chaudry, A. Moussa, O. and Kordzadeh, A. Lorenzi, B. Wilson, M. Patil, P. Noaman, I. Willem, J. Bouras, G. Evans, R. Singh, M. and Warrilow, H. Ahmad, A. Tewari, N. Yanni, F. Couch, J. and Theophilidou, E. Reilly, J. J. Singh, P. van Boxel, Gijs and Akbari, K. Zanotti, D. Sgromo, B. Sanders, G. and Wheatley, T. Ariyarathenam, A. Reece-Smith, A. Humphreys, L. and Choh, C. Carter, N. Knight, B. Pucher, P. and Athanasiou, A. Mohamed, I. Tan, B. Abdulrahman, M. and Vickers, J. Akhtar, K. Chaparala, R. Brown, R. Alasmar, M. M. A. Ackroyd, R. Patel, K. Tamhankar, A. Wyman, A. and Walker, R. Grace, B. Abbassi, N. Slim, N. Ioannidi, L. Blackshaw, G. Havard, T. Escofet, X. Powell, A. and Owera, A. Rashid, F. Jambulingam, P. Padickakudi, J. and Ben-Younes, H. Mccormack, K. Makey, I. A. Karush, M. K. and Seder, C. W. Liptay, M. J. Chmielewski, G. Rosato, E. L. and Berger, A. C. Zheng, R. Okolo, E. Singh, A. Scott, C. D. and Weyant, M. J. Mitchell, J. D. Oesophago-Gastric Anastomotic

Abstract

Background: No evidence currently exists characterising global outcomes following major cancer surgery, including esophageal cancer. Therefore, this study aimed to characterise impact of high income countries (HIC) versus low and middle income countries (LMIC) on the outcomes following esophagectomy for esophageal cancer. Method: This international multi-center prospective study across 137 hospitals in 41 countries included patients who underwent an esophagectomy for esophageal cancer, with 90-day follow-up. The main explanatory variable was country income, defined according to the World Bank Data classification. The primary outcome was 90-day postoperative mortality, and secondary outcomes were composite leaks (anastomotic leak or conduit necrosis) and major complications (Clavien-Dindo Grade III-V). Multivariable generalized estimating equation models were used to produce adjusted odds ratios (ORs) and 95% confidence intervals (CI95%). Results: Between April 2018 to December 2018, 2247 patients were included. Patients from HIC were more significantly older, with higher ASA grade, and more advanced tumors. Patients from LMIC had almost three-fold increase in 90-day mortality, compared to HIC (9.4% vs 3.7%, p < 0.001). On adjusted analysis, LMIC were independently associated with higher 90-day mortality (OR: 2.31, CI95%: 1.17-4.55, p = 0.015). However, LMIC were not independently associated with higher rates of anastomotic leaks (OR: 1.06, CI95%: 0.57-1.99, p = 0.9) or major complications (OR: 0.85, CI95%: 0.54-1.32, p = 0.5), compared to HIC. Conclusion: Resections in LMIC were independently associated with higher 90-day postoperative mortality, likely reflecting a failure to rescue of these patients following esophagectomy, despite similar composite anastomotic leaks and major complication rates to HIC. These findings warrant further research, to identify potential issues and solutions to improve global outcomes following esophagectomy for cancer. (C) 2020 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Published
2021

3. Postoperative outcomes in oesophagectomy with trainee involvement

Author

Evans, R. P. T. Hodson, J. Kamarajah, S. K. Griffiths, E. A. and Singh, P. Alderson, D. Bundred, J. Gossage, J. and Jefferies, B. McKay, S. Mohamed, I Nepogodiev, D. and Siaw-Acheampong, K. van Hillegersberg, R. Vohra, R. and Wanigasooriya, K. Whitehouse, T. Gjata, A. Moreno, I, J. and Takeda, F. R. Kidane, B. Castro, R. Guevara Harustiak, T. and Bekele, A. Kechagias, A. Gockel, I Kennedy, A. Da Roit, A. Bagajevas, A. Azagra, J. S. Mahendran, H. A. and Mejia-Fernandez, L. Wijnhoven, B. P. L. El Kafsi, J. Sayyed, R. H. Sousa, M. Sampaio, A. S. Negoi, I Blanco, R. and Wallner, B. Schneider, P. M. Hsu, P. K. Isik, A. and Gananadha, S. Wills, V Devadas, M. Duong, C. Talbot, M. and Hii, M. W. Jacobs, R. Andreollo, N. A. Johnston, B. and Darling, G. Isaza-Restrepo, A. Rosero, G. Arias-Amezquita, F. Raptis, D. Gaedcke, J. Reim, D. Izbicki, J. and Egberts, J. H. Dikinis, S. Kjaer, D. W. Larsen, M. H. and Achiam, M. P. Saarnio, J. Theodorou, D. Liakakos, T. and Korkolis, D. P. Robb, W. B. Collins, C. Murphy, T. and Reynolds, J. Tonini, V Migliore, M. Bonavina, L. and Valmasoni, M. Bardini, R. Weindelmayer, J. Terashima, M. and White, R. E. Alghunaim, E. Elhadi, M. Leon-Takahashi, A. M. and Medina-Franco, H. Lau, P. C. Okonta, K. E. Heisterkamp, J. Rosman, C. Beban, G. Babor, R. Gordon, A. and Rossaak, I, J. Pal, I, K. M. Qureshi, A. U. Naqi, S. A. and Syed, A. A. Barbosa, J. Vicente, C. S. Leite, J. Freire, J. Casaca, R. Costa, R. C. T. Scurtu, R. R. Mogoanta, S. S. Bolca, C. Constantinoiu, S. Sekhniaidze, D. So, J. B. Y. Gacvski, G. Loureiro, C. Pera, M. Bianchi, A. and Gijon, M. Moreno Fernandez, J. Martin Carrera, M. S. Trugeda and Vallve-Bernal, M. Pascual, M. A. Citores Elmahi, S. and Halldestam, I Hedberg, J. Monig, S. Gutknecht, S. Tez, M. Guner, A. Tirnaksiz, T. B. Colak, E. Sevinc, B. and Hindmarsh, A. Khan, I Khoo, D. Byrom, R. Gokhale, J. and Wilkerson, P. Jain, P. Chan, D. Robertson, K. Iftikhar, S. Skipworth, R. Forshaw, M. Higgs, S. Nijjar, R. and Viswanath, Y. K. S. Turner, P. Dexter, S. Boddy, A. and Allum, W. H. Oglesby, S. Cheong, E. Beardsmore, D. and Maynard, N. Berrisford, R. Mercer, S. Puig, S. Melhado, R. Kelty, C. Underwood, T. Dawas, K. Lewis, W. and Al-Bahrani, A. Bryce, G. Thomas, M. Arndt, A. T. and Palazzo, F. Meguid, R. A. Fergusson, J. Beenen, E. and Mosse, C. Salim, J. Cheah, S. Wright, T. Cerdeira, M. P. and McQuillan, P. Richardson, M. Liem, H. Spillane, J. and Yacob, M. Albadawi, F. Thorpe, T. Dingle, A. Cabalag, C. and Loi, K. Fisher, O. M. Ward, S. Read, M. Johnson, M. and Bassari, R. Bui, H. Cecconello, I Sallum, R. A. A. and da Rocha, J. R. M. Lopes, L. R. Tercioti, Jr., V. Coelho, J. D. S. Ferrer, J. A. P. Buduhan, G. Tan, L. Srinathan, S. and Shea, P. Yeung, J. Allison, F. Carroll, P. and Vargas-Barato, F. Gonzalez, F. Ortega, J. Nino-Torres, L. and Beltran-Garcia, T. C. Castilla, L. Pineda, M. Bastidas, A. Gomez-Mayorga, J. Cortes, N. Cetares, C. Caceres, S. and Duarte, S. Pazdro, A. Snajdauf, M. Faltova, H. and Sevcikova, M. Mortensen, P. B. Katballe, N. Ingemann, T. and Morten, B. Kruhlikava, I Ainswort, A. P. Stilling, N. M. and Eckardt, J. Holm, J. Thorsteinsson, M. Siemsen, M. and Brandt, B. Nega, B. Teferra, E. Tizazu, A. Kauppila, J. S. Koivukangas, V Merilainen, S. Gruetzmann, R. Krautz, C. Weber, G. Golcher, H. Emons, G. Azizian, A. and Ebeling, M. Niebisch, S. Kreuser, N. Albanese, G. Hesse, J. Volovnik, L. Boecher, U. Reeh, M. Triantafyllou, S. and Schizas, D. Michalinos, A. Baili, E. Mpoura, M. and Charalabopoulos, A. Manatakis, D. K. Balalis, D. Bolger, J. and Baban, C. Mastrosimone, A. McAnena, O. Quinn, A. and Suilleabhain, C. B. O. Hennessy, M. M. Ivanovski, I. Khizer, H. Ravi, N. Donlon, N. Cervellera, M. Vaccari, S. and Bianchini, S. Sartarelli, L. Asti, E. Bernardi, D. and Merigliano, S. Provenzano, L. Scarpa, M. Saadeh, L. and Salmaso, B. De Manzoni, G. Giacopuzzi, S. La Mendola, R. and De Pasqual, C. A. Tsubosa, Y. Niihara, M. Irino, T. and Makuuchi, R. Ishii, K. Mwachiro, M. Fekadu, A. Odera, A. and Mwachiro, E. AlShehab, D. Ahmed, H. A. Shebani, A. O. and Elhadi, A. Elnagar, F. A. Elnagar, H. F. Makkai-Popa, S. T. Wong, L. F. Yunrong, T. Thanninalai, S. Aik, H. C. and Soon, P. W. Huei, T. J. Basave, H. N. L. and Cortes-Gonzalez, R. Lagarde, S. M. van Lanschot, J. J. B. and Cords, C. Jansen, W. A. Martijnse, I Matthijsen, R. and Bouwense, S. Klarenbeek, B. Verstegen, M. van Workum, F. and Ruurda, J. P. van der Veen, A. van den Berg, J. W. Evenett, N. Johnston, P. Patel, R. MacCormick, A. Young, M. and Smith, B. Ekwunife, C. Memon, A. H. Shaikh, K. Wajid, A. and Khalil, N. Haris, M. Mirza, Z. U. Qudus, S. B. A. and Sarwar, M. Z. Shehzadi, A. Raza, A. Jhanzaib, M. H. and Farmanali, J. Zakir, Z. Shakeel, O. Nasir, I Khattak, S. and Baig, M. Noor, M. A. Ahmed, H. H. Naeem, A. Pinho, A. C. da Silva, R. Bernardes, A. Campos, J. C. Matos, H. and Braga, T. Monteiro, C. Ramos, P. Cabral, F. Gomes, M. P. Martins, P. C. Correia, A. M. Videira, J. F. and Ciuce, C. Drasovean, R. Apostu, R. Paitici, S. Racu, A. E. Obleaga, V, C. Beuran, M. Stoica, B. Ciubotaru, C. and Negoita, V Cordos, I Birla, R. D. Predescu, D. and Hoara, P. A. Tomsa, R. Shneider, V Agasiev, M. Ganjara, I Gunjic, D. Veselinovic, M. Babic, T. Chin, T. S. and Shabbir, A. Kim, G. Crnjac, A. Samo, H. del Val, I. Diez and Leturio, S. Ramon, J. M. Dal Cero, M. Rifa, S. Rico, M. Pomar, A. Pagan Corcoles, J. A. Martinez Miravalles, J. L. Rodicio Pais, S. A. Turienzo, S. A. Alvarez, L. S. and Campos, V, P. Rendo, A. G. Garcia, S. S. Santos, E. P. G. and Martinez, E. T. Diaz, M. J. Fernandez Alvarez, C. Magadan and Martin, V. Concepcion Lopez, C. Diaz Rodrigo, A. Rosat and Sanchez, L. E. Perez Cuadrado, M. Bailon Carrasco, C. Tinoco and Bhojwani, E. Choolani Sanchez, D. P. Ahmed, M. E. Dzhendov, T. Lindberg, F. Rutegard, M. Sundbom, M. Mickael, C. and Colucci, N. Schnider, A. Er, S. Kurnaz, E. Turkyilmaz, S. Turkyilmaz, A. Yildirim, R. Baki, B. E. Akkapulu, N. and Karahan, O. Damburaci, N. Hardwick, R. Safranek, P. and Sujendran, V Bennett, J. Afzal, Z. Shrotri, M. Chan, B. and Exarchou, K. Gilbert, T. Amalesh, T. Mukherjee, D. and Mukherjee, S. Wiggins, T. H. Kennedy, R. McCain, S. and Harris, A. Dobson, G. Davies, N. Wilson, I Mayo, D. and Bennett, D. Young, R. Manby, P. Blencowe, N. Schiller, M. Byrne, B. Mitton, D. Wong, V Elshaer, A. Cowen, M. Menon, V Tan, L. C. McLaughlin, E. Koshy, R. and Sharp, C. Brewer, H. Das, N. Cox, M. Al Khyatt, W. and Worku, D. Iqbal, R. Walls, L. McGregor, R. Fullarton, G. and Macdonald, A. MacKay, C. Craig, C. Dwerryhouse, S. and Hornby, S. Jaunoo, S. Wadley, M. Baker, C. Saad, M. and Kelly, M. Davies, A. Di Maggio, F. Mistry, P. Singhal, R. Tucker, O. Kapoulas, S. Powell-Brett, S. Davis, P. and Bromley, G. Watson, L. Verma, R. Ward, J. Shetty, V and Ball, C. Pursnani, K. Sarela, A. Ling, H. Sue Mehta, S. Hayden, J. To, N. Palser, T. Hunter, D. and Supramaniam, K. Butt, Z. Ahmed, A. Kumar, S. Chaudry, A. and Moussa, O. Kordzadeh, A. Patil, P. Noaman, I Willem, J. Bouras, G. Evans, R. Singh, M. Warrilow, H. and Ahmad, A. Tewari, N. Yanni, F. Couch, J. Theophilidou, E. Reilly, J. J. van Boxel, G. Akbari, K. Zanotti, D. and Sgromo, B. Sanders, G. Wheatley, T. Ariyarathenam, A. and Reece-Smith, A. Humphreys, L. Choh, C. Carter, N. and Knight, B. Pucher, P. Athanasiou, A. Tan, B. and Abdulrahman, M. Vickers, J. Akhtar, K. Chaparala, R. and Brown, R. Alasmar, M. M. A. Ackroyd, R. Patel, K. and Tamhankar, A. Wyman, A. Walker, R. Grace, B. Abbassi, N. and Slim, N. Ioannidi, L. Blackshaw, G. Havard, T. and Escofet, X. Powell, A. Owera, A. Rashid, F. Jambulingam, P. Padickakudi, J. Ben-Younes, H. McCormack, K. Makey, I. A. Karush, M. K. Seder, C. W. Liptay, M. J. and Chmielewski, G. Rosato, E. L. Berger, A. C. Zheng, R. and Okolo, E. Singh, A. Scott, C. D. Weyant, M. J. Mitchell, J. D. West Midlands Res Collaborative

Abstract

Background The complexity of oesophageal surgery and the significant risk of morbidity necessitates that oesophagectomy is predominantly performed by a consultant surgeon, or a senior trainee under their supervision. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on postoperative outcomes in an international multicentre setting. Methods Data from the multicentre Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were analysed, which comprised prospectively collected data from patients undergoing oesophagectomy for oesophageal cancer between April 2018 and December 2018. Procedures were grouped by the level of trainee involvement, and univariable and multivariable analyses were performed to compare patient outcomes across groups. Results Of 2232 oesophagectomies from 137 centres in 41 countries, trainees were involved in 29.1 per cent of them (n = 650), performing only the abdominal phase in 230, only the chest and/or neck phases in 130, and all phases in 315 procedures. For procedures with a chest anastomosis, those with trainee involvement had similar 90-day mortality, complication and reoperation rates to consultant-performed oesophagectomies (P = 0.451, P = 0.318, and P = 0.382, respectively), while anastomotic leak rates were significantly lower in the trainee groups (P = 0.030). Procedures with a neck anastomosis had equivalent complication, anastomotic leak, and reoperation rates (P = 0.150, P = 0.430, and P = 0.632, respectively) in trainee-involved versus consultant-performed oesophagectomies, with significantly lower 90-day mortality in the trainee groups (P = 0.005). Conclusion Trainee involvement was not found to be associated with significantly inferior postoperative outcomes for selected patients undergoing oesophagectomy. The results support continued supervised trainee involvement in oesophageal cancer surgery. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on perioperative outcomes in the international multicentre Oesophago-Gastric Anastomosis Audit (OGAA). Analysis of 2232 oesophagectomies has shown that trainee involvement did not negatively impact perioperative outcomes.

Published
2021

5. Een man met pijn op de borst en dyspneu

Author

van Adrichem, Stefan, Didden, Paul, and van Lanschot, J J B Jan

Subjects
Male, Chest Pain, Peptic Ulcer, Esophageal Neoplasms, English Abstract, Case Reports, Middle Aged, digestive system diseases, Esophagectomy, Esophageal Fistula, Dyspnea, Journal Article, Humans, Pericarditis
Abstract

A 60-year-old man presented with acute chest pain and dyspnoea, which was caused by pericarditis secondary to a neo-oesophago-pericardial fistula after previous oesophagectomy for oesophageal cancer. The fistula presumably originated from a penetrating peptic ulcer.

Published
2015

6. J-pouch vs side-to-end coloanal anastomosis after preoperative radiotherapy and total mesorectal excision for rectal cancer: A multicentre randomized trial

Author

Doeksen, A., Bakx, R., Vincent, A., van Tets, W. F., Sprangers, M. A. G., Gerhards, M. F., Bemelman, W. A., van Lanschot, J. J. B., Other Research, Pediatrics, Paediatric Surgery, CCA -Cancer Center Amsterdam, APH - Amsterdam Public Health, Medical Psychology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, and Surgery

Abstract

Aim Comparison of functional and surgical outcome of the J-pouch with the side-to-end coloanal anastomosis after preoperative radiotherapy and total mesorectal excision in rectal cancer patients. Method In a multicentre study, patients with a carcinoma of the lower two-thirds of the rectum were randomized to either a J-pouch or a side-to-end reconstruction. Primary outcome was function of the neorectum 1year after surgery. A functional outcome [COloREctal Functional Outcome (COREFO)] questionnaire, and two quality of life questionnaires (EORTC-QLQ-CR38 and SF-36) were to be completed by all participants preoperatively, and 4 and 12months postoperatively. Independent data managers recorded surgical outcome. A group size of 30 patients in each group was calculated based on a 15-point difference of the COREFO scale. Results In total, 107 patients were randomized, 55 in the J-pouch group and 52 in the side-to-end anastomosis group. The COREFO incontinence scale at 4months and the total functional outcome at 4 and 12months showed better results for the J-pouch group in comparison with the side-to-end anastomosis group. The remaining COREFO scales (frequency, social impact, stool-related aspects and bowel medication), surgical outcome (complications, reoperations, length of hospital stay, readmissions and mortality) and quality of life did not show significant differences between treatment groups. Conclusion The overall results of a coloanal J-pouch and a side-to-end anastomosis are comparable, although functional results are slightly better with a J-pouch. The side-to-end anastomosis is technically less demanding and therefore a justified alternative in sphincter-saving surgery.

Published
2012

7. Analysis of micrometastatic disease in histologically negative lymph nodes of patients with adenocarcinoma of the distal esophagus or gastric cardia

Author

Buskens, C. J., ten Kate, F. J. W., Obertop, H., Izbicki, J. R., van Lanschot, J. J. B., Other departments, Amsterdam Gastroenterology Endocrinology Metabolism, Cancer Center Amsterdam, Pathology, and Surgery

Abstract

SUMMARY: Lymphatic dissemination is the most important prognostic factor in patients with esophageal carcinoma. However, the clinical significance of lymph node micrometastases is still debated due to contradictory results. The aim of the present study was to identify the incidence of potentially relevant micrometastatic disease in patients with histologically node-negative esophageal adenocarcinoma and to analyze the sensitivity and specificity of three different immunohistochemical assays. From a consecutive series of 79 patients who underwent a transthoracic resection with extended 2-field lymphadenectomy, all 20 patients with pN0 esophageal adenocarcinoma were included in this study. A total of 578 lymph nodes were examined for the presence of micrometastases by immunohistochemical analysis with the antibodies Ber-EP4, AE1/AE3 and CAM 5.2. Lymph node micrometastases were detected in five of the 20 patients (25%). They were identified in 16 of the 578 lymph nodes examined (2.8%) and most frequently detected with the Ber-EP4 and AE1/AE3 antibody (sensitivity 95% and 79% respectively). In 114 of the 559 negative lymph nodes (20.4%), positive single cells were found that did not demonstrate malignant characteristics. These false-positive cells were more frequently found with the AE1/AE3 staining (specificity of the Ber-Ep4 and AE1/AE3 antibody 94% and 84% respectively). The presence of nodal micrometastases was associated with the development of locoregional recurrences (P=0.01), distant metastases (P=0.01), and a reduced overall survival (log rank test, P=0.009). For the detection of clinically relevant micrometastatic disease in patients operated upon for adenocarcinoma of the distal esophagus or gastric cardia, Ber-EP4 is the antibody of first choice because of its high sensitivity and specificity. Immunohistochemically detected micrometastases in histologically negative lymph nodes have potential prognostic significance and are associated with a high incidence of both locoregional and systemic recurrence. Therefore, this technique has the potential to refine the staging system for esophageal cancer and to help identify patients who will not be cured by surgery alone

Published
2008

8. Patients' perception of diagnostic tests in the preoperative assessment of esophageal cancer

Author

Westerterp, M., van Westreenen, H. L., Deutekom, M., Stoker, J., Fockens, P., Comans, E. F. I., Plukker, J. T. M., Bossuyt, P. M. M., van Lanschot, J. J. B., Sloof, G. W., Surgery, Public and occupational health, Amsterdam Gastroenterology Endocrinology Metabolism, Cancer Center Amsterdam, Radiology and Nuclear Medicine, Gastroenterology and Hepatology, Amsterdam Public Health, Epidemiology and Data Science, and Nuclear Medicine

Published
2008

9. Primair coloncarcinoom in een coloninterponaat na oesofagusresectie

Author

Roos, D., Busch, O. R. C., van Lanschot, J. J. B., Landsteiner Laboratory, Amsterdam Gastroenterology Endocrinology Metabolism, Cancer Center Amsterdam, and Surgery

Subjects
digestive system diseases
Abstract

A 79-year-old man presented with a massive subcutaneous swelling due to extreme dilatation ofa subcutaneously interposed right-sided hemicolon; 7 years earlier he had undergone oesophageal resection and gastric tube reconstruction for a poorly differentiated adenocarcinoma of the distal oesophagus. The procedure was complicated by gastric tube necrosis, and the tube was removed. One year later the continuity of the gastrointestinal tract was restored by a right-sided isoperistaltic colon graft: the terminal ileum, including the ileocecal valve, was anastomosed to the pre-existing cervical portion of the oesophagus. The dilatation was caused by an obstructive adenocarcinoma located in the distal part of the interposed colon in combination with an intact ileocecal valve in the neck. The tumour was a primary colon carcinoma with no evidence of further dissemination. The colon graft was removed, and the patient received a definitive salivary fistula placed in the neck and permanent feeding tube by jejunostomy. Development of primary colon carcinoma in a colon graft is rare; 7 cases have been reported in the literature so far. Routine endoscopic follow-up of a graft does not appear to be warranted, but endoscopy should be performed if symptoms arise

Published
2007

10. Surgery, radiotherapy, and chemotherapy for esophageal carcinoma

Author

van Lanschot, J. J., González González, D., Richel, D. J., and Other departments

Subjects
Gastroenterology
Abstract

Over the last year, several interesting studies have been published on the treatment of esophageal carcinoma. Surprisingly, none of them was a randomized phase III trial. The debate on the necessary extent of a potentially curative surgical resection is ongoing. After initially disappointing results, the innovative technique of minimally invasive surgery draws new attention, but clear advantages for the endoscopic approach are yet to emerge. An updated meta-analysis on the value of preoperative radiotherapy showed negative results. There is a clear tendency toward combined-modality treatment, especially in patients with more advanced disease. Some new chemotherapeutic agents showed promising preliminary results (especially paclitaxel), whereas others were clearly disappointing (eg, gemcitabine, topotecan). Concurrent chemoradiation as primary treatment for proximal (cervical) tumors was remarkably effective.

Published
2006

11. Oesofagus

Author

van Lanschot, J. J. B., Gooszen, H. G., Aronson, D. C., Blankensteijn, J. D., Gouma, D. J., Kroon, B. B. R., Lange, J. F., van Vugt, A. B., and Surgery

Published
2006

12. Compartimentalization for chylothorax originating from the abdomen after extended esophagectomy. Report of two cases and review of the literature

Author

Omloo, J. M. T., Lagarde, S. M., Vrouenraets, B. C., Busch, O. R. C., van Lanschot, J. J. B., Surgery, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, and CCA -Cancer Center Amsterdam

Abstract

BACKGROUND: Chyle leakage from the chest after extended esophagectomy originating from the abdomen is a rare complication with various clinical presentations and treatments. METHODS: Two cases of chylothorax originating from the abdomen are discussed and the literature concerning diagnosis, management and outcome is reviewed. RESULTS AND CONCLUSION: Initially conservative measures should be installed; however, prolonged conservative treatment should be avoided. Reoperation gives an opportunity to identify the leak. If the leakage originates from the abdomen, compartimentalization is the essential step to solve the problem

Published
2006

15. Fetal incontinance. Surgical aspects

Author

Baeten, C. G. M. I., Slors, J. F. M., Koch, S. M. P., van Lanschot, J. J. B., Gouma, D. J., Tytgat, G. N. J., Jansen, P. L. M., Jones, E. A., Pinedo, H. M., Schouten, W. R., and Surgery

Published
2005

17. Gallstone disease. Surgical aspects

Author

Gouma, D. J., Terpstra, O. T., van Lanschot, J. J. B., Tytgat, G. N. J., Jansen, P. L. M., Jones, E. A., Pinedo, H. M., Schouten, W. R., and Surgery

Published
2005

18. Integrated medical and surgical gastroenterology

Author

van Lanschot, J. J. B., Gouma, D. J., Tytgat, G. N. J., Jansen, P. L. M., Jones, E. A., Pinedo, H. M., Schouten, W. R., Surgery, Extramural researchers, Amsterdam Gastroenterology Endocrinology Metabolism, and Gastroenterology and Hepatology

Published
2005

19. Morbid obesity

Author

Mathus-Vliegen, E. M. H., Romijn, J. A., Belachew, M., Greve, J. W., van Lanschot, J. J. B., Gouma, D. J., Tytgat, G. N. J., Jansen, P. L. M., Jones, E. A., Pinedo, H. M., Schouten, W. R., Gastroenterology and Hepatology, and Other departments

Published
2005

20. Cancer of the eosophagus and gastroesophageal junction

Author

Siersema, P. D., Fockens, P., Lerut, T., van Lanschot, J. J. B., Koning, C. C. E., van der Gaast, A., Gouma, D. J., Tytgat, G. N. J., Jansen, P. L. M., Jones, E. A., Pinedo, H. M., Schouten, W. R., Amsterdam Gastroenterology Endocrinology Metabolism, Cancer Center Amsterdam, Gastroenterology and Hepatology, Surgery, and Radiotherapy

Published
2005

21. Palliatieve behandeling voor slokdarmkanker met passageklachten: gunstiger uitkomsten van eenmalige inwendige brachytherapie dan van plaatsing van een zelfexpanderende stent; multicentrisch, gerandomiseerd onderzoek

Author

Homs, M. Y. V., Steyerberg, E. W., Eijkenboom, W. M. H., Tilanus, H. W., Stalpers, L. J. A., Bartelsman, J. F. W. M., van Lanschot, J. J. B., Wijrdeman, H. K., Mulder, C. J. J., Reinders, J. G., Boot, H., Aleman, B. M. P., Kuipers, E. J., Siersema, P. D., CCA -Cancer Center Amsterdam, Radiotherapy, Gastroenterology and Hepatology, and Surgery

Subjects
otorhinolaryngologic diseases
Abstract

OBJECTIVE: To compare the results of single-dose internal irradiation (brachytherapy) and self-expanding metal stent placement in the palliation of oesophageal obstruction due to cancer of the oesophagus. DESIGN: Randomised trial. METHOD: In the period from December 1999-Jun 2002, 209 patients with dysphagia due to inoperable carcinoma of the oesophagus were randomised to placement of an Ultraflex stent (n = 108) or single-dose (12 Gy) brachytherapy (n = 101). Primary outcome was relief of dysphagia; secondary outcomes were complications, persistent or recurrent dysphagia, health-related quality of life, and costs. Patients were followed up by monthly home visits from a specialised nurse. RESULTS: Dysphagia improved more rapidly after stent placement than after brachytherapy, but long-term relief of dysphagia was better after brachytherapy. Stent placement resulted in more complications than did brachytherapy (36/108 (33%) versus 21/101 (21%); p = 0.02), due mainly to an increased incidence of late haemorrhage in the stent group (14 versus 5; p = 0.05). The groups did not differ with regard to the incidence of persistent or recurrent dysphagia or median survival (p > 0.20). In the long term, quality-of-life scores were higher in the brachytherapy group. Total medical costs were also similar for both treatments: Euro 8,215 for stent placement and Euro 8,135 for brachytherapy. CONCLUSION: Brachytherapy provided better long-term relief of dysphagia than did stent placement and also produced fewer complications. Brachytherapy is therefore recommended as the preferred treatment for the palliation of dysphagia due to oesophageal cancer

Published
2005

23. Chronic pancreatitis. Surgical aspects

Author

van Gulik, T. M., Eddes, E. H., van Lanschot, J. J. B., Gouma, D. J., Tytgat, G. N. J., Jansen, P. L. M., Jones, E. A., Pinedo, H. M., Schouten, W. R., Amsterdam Gastroenterology Endocrinology Metabolism, and Surgery

Published
2005

24. Motility disorders of the proximal gastrointestinal tract (Gastrointestinal aspects)

Author

Tack, J., Boeckxstaens, G. E. E., Simmermacher, R. K. J., Busch, O. R. C., van Lanschot, J. J. B., Gouma, D. J., Tytgat, G. N. J., Jansen, P. L. M., Jones, E. A., Pinedo, H. M., Schouten, W. R., Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, Cancer Center Amsterdam, and Surgery

Published
2005

25. Antimicrobiol prophylaxis and therapy

Author

Hoepelman, I. M., Ramsay, G., Speelman, P., van Lanschot, J. J. B., Gouma, D. J., Tytgat, G. N. J., Jansen, P. L. M., Jones, E. A., Pinedo, H. M., Schouten, W. R., Amsterdam institute for Infection and Immunity, and Infectious diseases

Published
2005

26. Preface

Author

van Lanschot, J. J. B., Gouma, D. J., and Surgery

Published
2005

29. Inflammatory bowel disease. Surgical aspects

Author

van Laarhoven, C. J. H. M., Bemelman, W. A., van Lanschot, J. J. B., Gouma, D. J., Tytgat, G. N. J., Jansen, P. L. M., Jones, E. A., Pinedo, H. M., Schouten, W. R., Amsterdam Gastroenterology Endocrinology Metabolism, and Surgery

Published
2005

31. Blunt and penetrating abdominal trauma

Author

Goslings, J. C., van der Linden, C. J., van Lanschot, J. J. B., Gouma, D. J., Tytgat, G. N. J., Jansen, P. L. M., Jones, E. A., Pinedo, H. M., Schouten, W. R., Amsterdam Movement Sciences, and Surgery

Published
2005

32. Perianal fistulas

Author

Schouten, W. R., Stoker, J., van Tets, W. F., van Lanschot, J. J. B., Gouma, D. J., Tytgat, G. N. J., Jansen, P. L. M., Jones, E. A., Pinedo, H. M., Surgery, Radiology & Nuclear Medicine, Radiology and Nuclear Medicine, CCA - Imaging and biomarkers, Amsterdam Gastroenterology Endocrinology Metabolism, and Cancer Center Amsterdam

Published
2004

34. De para-oesofageale hernia; een zeldzame hiatushernia die een eigen aanpak vereist

Author

Peeters, M. T., Wijsman, J. H., van Lanschot, J. J., and Surgery

Subjects
stomatognathic diseases, surgical procedures, operative, digestive system diseases
Abstract

In three patients, a woman aged 87 years who presented with signs indicating a myocardial infarction, a man aged 31 suffering from postprandial epigastric pain that suddenly worsened, and a woman aged 60 years with longstanding postprandial pain and recent fatigue due to anaemia, a para-oesophageal hernia was diagnosed. Para-oesophageal herniation is an uncommon disorder accounting for approximately 5% of all hernias at the oesophageal hiatus. They are distinguished from the more common sliding hiatal hernia by a relative preservation of the intra-abdominal fixation of the gastro-oesophageal junction. These patients show that the clinical presentation of para-oesophageal rolling hernias is different from that of sliding hernias. Pathological reflux may occur; though symptoms associated with a relative obstruction of the stomach within the hernia sac, such as dysphagia, are more common. Rare non-specific symptoms such as anaemia and loss of weight are also seen. Adequate therapy differs from that of a sliding hernia and should be individualized: surgical correction is indicated in a healthy patient with a symptomatic para-oesophageal hernia, such as in the last patient. However, when the hernia is incidentally diagnosed or when comorbidity is present, such as in the first patient, a wait-and-see policy is recommended. Only in case of a threatening incarceration, such as in the second patient, is an emergency operation indicated

Published
2004

35. COX-2 in cancer

Author

Saukkonen, K., Buskens, C. J., Sivula, A., van Rees, B. P., Erkinheimo, T. L., Rintahaka, J., Pohjola, L., van Lanschot, J. J. B., Offerhaus, G. J. A., Haglund, C., Ristimäki, A., Pairet, M., van Ryn, J., Other departments, Surgery, and Pathology

Published
2004

36. De melkgangfistel: een hardnekkig probleem dat adequaat is te behandelen

Author

Tinnemans, J. G., van Lanschot, J. J., and Surgery

Abstract

Three female patients, 39, 39 and 46 years old, had recurrent, non-puerperal, subareolar abscesses caused by obstructed and dilated lactiferous ducts and resulting in paramamillary fistulas. Further recurrence was stopped by surgery. Based on the pathogenesis, surgery is the recommended treatment for this chronic ailment, i.e. fistulectomy using a radial incision through the centre of the nipple and excising the pathological nipple-areolar complex. Only the nipple is reconstructed, leaving the remainder of the wound open for healing by secondary intention and thus preventing recurrence

Published
2004

37. Laparoscopische resectie van coloncarcinoom

Author

Tuynman, J. B., Bemelman, W. A., van Lanschot, J. J. B., Surgery, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism

Abstract

Although the laparoscopic treatment of colon cancer was introduced more than a decade ago, its application is still under debate. The minimally invasive approach slightly shortens postoperative recovery and hospital-stay as compared to open resection of colon cancer. The disease-free and overall survival following the laparoscopic resection of colon cancer are similar to those of the open procedure, but the data are still limited. Over the next few years, more solid data will become available concerning the effects on long-term survival, quality of life and cost-effectiveness. At present, wide application outside of clinical trials should not be favoured. The laparoscopic technique has a long learning curve and can only be offered as a safe procedure if sufficient expertise is available

Published
2004

38. Cyclo-oxygenase(COX)-2-remming bij de preventie en de behandeling van colorectaal carcinoom

Author

Tuynman, J. B., Hulscher, J. B., Steller, E. Ph, van Lanschot, J. J., Richel, D. J., Surgery, Cancer Center Amsterdam, and Oncology

Subjects
digestive system diseases
Abstract

Epidemiological studies have found that long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with a lower risk of colorectal cancer (CRC). Cyclooxygenase (COX)-2 expression is present in colorectal cancer and overexpression is associated with metastases and poorer prognosis in multivariate analysis. NSAID treatment results in a reduction of the incidence of colorectal adenoma in patients with familial adenomatous polyposis, in patients with a history of colorectal adenomas and in patients with a history of CRC. Pre-clinical research shows that COX-2 expression is associated with cell proliferation, angiogenesis, apoptosis inhibition and local immune-down modulation. An anticarcinogenic effect has been shown specifically in selective COX-2 inhibitors in animal models. Selective COX-2 inhibitors have fewer adverse effects than the non-selective NSAIDs and are promising chemopreventative and chemotherapeutical agents. The effects of selective COX-2 inhibition in the prevention of and treatment for colorectal carcinoma will be investigated in clinical randomized multicentre trials

Published
2003

39. Primair adenocarcinoom van de dunne darm

Author

van Lieshout, A. P., van Hillegersberg, R., Richel, D. J., van Slooten, H. J., van Lanschot, J. J., Cancer Center Amsterdam, Oncology, and Surgery

Abstract

Three patients, a woman aged 46 years and two men aged 81 and 62 years, presented with abdominal pain, nausea, vomiting and/or weight loss. A small intestine follow-through series revealed a significant stenosis in all 3 patients. A laparotomic partial resection of the affected jejunum and corresponding mesentery was performed. A primary adenocarcinoma of the small intestine was diagnosed; pathology revealed that the resections were radical, and pT3N0, pT2N0 and pT3N0 stage tumours respectively. The first patient underwent a repeat operation four months later due to similar complaints caused by a tumour recurrence; fifteen months later she died from recurrent disease. The second patient was disease-free 3 years after surgery. In the third patient, liver and peritoneal metastases developed 16 months after surgery; he died 10 months after palliative chemotherapy had been initiated. Adenocarcinoma of the small intestine is a rare disease and patients often present late with aspecific complaints. This, combined with the fact that these tumours tend to follow an aggressive course, results in a poor five-year survival rate of 10-35%. Surgery is the only curative treatment currently available. A greater awareness of this type of tumour is needed for treatment results to improve

Published
2003

41. Barrett-slokdarm: endoscopische behandeling van hooggradige dysplasie en vroegcarcinomen

Author

Bergman, J. J., Marsman, W. A., Krishnadath, K. K., Fockens, P., van Lanschot, J. J., Tytgat, G. N., Amsterdam Gastroenterology Endocrinology Metabolism, Cancer Center Amsterdam, Gastroenterology and Hepatology, Surgery, and Extramural researchers

Abstract

In a Barrett's oesophagus without dysplasia, endoscopic control every 3-5 years is sufficient. If low-grade dysplasia is encountered in the surveillance biopsies, then endoscopy should be repeated within 3-6 months and yearly thereafter if the low-grade dysplasia persists. Antacid medication must be prescribed in cases with extensive inflammation. The endoscopic treatment of patients with high-grade dysplasia and/or early cancer of the mucosa in a Barrett's oesophagus (tissue ablation and/or mucosa resection) seems a promising alternative to surgery in view of the combination of effectiveness, limited invasiveness compared to surgical resection, and the preservation of a functional oesophagus. Data from long-term follow-up are still limited. Strict endoscopic surveillance will probably detect metachronic abnormalities in an early and still curable stage, creating a new opportunity for endoscopic treatment

Published
2003

42. Transhiatale of transthoracale resectie van een oesofaguscarcinoom: afstemmen op tumorlocatie, positieve hoog-thoracale lymfklieren en preoperatieve fysieke toestand

Author

van Lanschot, J. J., Tilanus, H. W., Obertop, H., and Surgery

Abstract

The limited transhiatal resection for the surgical treatment of oesophageal cancer is aimed at limiting early postoperative complications by not performing lateral thoracotomy and formal lymphadenectomy. The extended transthoracic approach with two-field lymphnode dissection is intended to improve long-term survival. The recurrence pattern after transhiatal resection suggests that a subgroup of patients might benefit from the more extended approach. In a large randomized trial in two high-volume Dutch academic hospitals, extended resection resulted in more postoperative (pulmonary) complications and a prolonged postoperative recovery time, but when compared to transhiatal resection, had only a limited impact on quality of life. The estimated 5-year survival advantage after extended resection was 10% (95% confidence interval: -3% to +23%). Subgroup analysis indicated a 17% 5-year survival advantage for patients with oesophageal cancer, but only a 1% advantage for patients with cancer of the cardia or gastro-oesophageal junction. The individualized operative approach for patients with potentially curable oesophageal cancer is based on tumour location, positive high-thoracic lymph nodes and preoperative physical condition

Published
2003

44. Oogklachten wijzend op een tumor elders in het lichaam

Author

Marinkovic, M., van Lanschot, J. J. B., Schlingemann, R. O., de Smet, M. D., Saeed, P., Surgery, and Ophthalmology

Subjects
genetic structures, sense organs, eye diseases
Abstract

A variety of clinical presentations of malignant tumour metastases outside of the eye and orbit, were seen in four patients: a 52-year-old man who was scheduled to have a surgical removal of an oesophageal carcinoma and who presented with retinal detachment, a 58-year-old woman in whom retinopathy was the first sign of a cervical carcinoma (cancer-associated retinopathy), a 71-year-old man who had been treated for colon carcinoma and who presented with an orbital mass, and finally a 67-year-old woman with an orbital mass as the first sign of a Grawitz tumour. Metastasis should be considered in patients with a history of malignancy, who present with ophthalmologic complaints. Further it should be borne in mind that eye problems can be the first sign of oncological disease outside the eye

Published
2002

46. Positive peritruncal nodes for esophageal carcinoma. not always a dismal prognosis

Author

Hulscher, J. B., Buskens, C. J., Bergman, J. J., Fockens, P., van Lanschot, J. J., Obertop, H., and Other departments

Abstract

For esophageal carcinoma, positive truncal nodes are considered distant metastases, and might be a contraindication for potentially curative surgery. With the development of new diagnostic tools more/smaller peritruncal nodes may be found positive preoperatively. We evaluate whether it is justified to exclude all patients with positive peri-truncal nodes from curative surgery. Retrospective study of all patients undergoing transhiatal resection for a mid-/distal esophageal carcinoma between 1993 and 1997. 110 patients underwent transhiatal resection for esophageal carcinoma. Sixteen patients had tumor-positive, resectable peritruncal lymph nodes not identified preoperatively, changing preoperative stage III into postoperative stage IV (M1a). After follow-up of 2.9 years (0.07-7.6), 49 patients (45%) were alive. On multivariate analysis radicality and lymph node status were independent prognostic factors. There was no significant difference in survival between stage III and stage IV (M1a) tumors: 1.7 and 1.5 years, respectively (p = 0.87). At the end of follow-up, 4/16 patients (25%) with stage IV (M1a) disease were alive without evidence of disease. The presence of malignant cells in small, resectable peritruncal nodes does not preclude long-term survival. The results of new diagnostic modalities should be interpreted cautiously, until firm criteria for irresectability/incurability of positive truncal nodes are established

Published
2001

47. Diagnose in beeld (49). Diagnose. Megaoesofagus bij achalasie

Author

Busch, O. R., Bartelsman, J. F., van Lanschot, J. J., and Other departments

Subjects
otorhinolaryngologic diseases, digestive system diseases
Abstract

Already as a child a 49-year-old man suffered from cough, regurgitation and dysfagia. He had a mega-esophagus, caused by achalasia. He was successfully treated by resection of the esophagus and intrathoracic gastric bypass

Published
2001

48. Verwisseling van patiëntenmateriaal: DNA-microsatellietanalyse als snelle identificatiemethode

Author

Noorduyn, L. A., Davids, P. H., van Lanschot, J. J., van Noesel, C. J., and Other departments

Abstract

In a man aged 56 years with dysphagia, an oesophageal biopsy was found to contain an adenocarcinoma. In view of the discrepancy between the clinical and the histological pictures, the biopsy was repeated; in a second biopsy no carcinoma was demonstrable. DNA microsatellite analysis proved that the first biopsy originated from another person. The scheduled oesophageal resection was cancelled and the patient was reassured. A woman aged 77 years underwent gastrectomy because of biopsy samples with adenocarcinoma. However, no tumour was found in the resected stomach. DNA microsatellite analysis showed that the biopsy samples indeed originated from the patient. Unfortunately, mix-up of patient specimens occasionally occurs. Especially a discrepancy between the clinical picture and the histological diagnosis must raise the suspicion of a specimen mix-up. In such cases, DNA microsatellite analysis can give a rapid and reliable answer whether a mix-up has indeed taken place

Published
2001

49. Role of nitric oxide in the regulation of glucose kinetics in response to endotoxin in dogs

Author

Moeniralam, H. S., Sprangers, F., Endert, E., Ackermans, M. T., van Lanschot, J. J., Sauerwein, H. P., Romijn, J. A., and Other departments

Abstract

The purpose of the present in vivo study was to determine the role of nitric oxide (NO) in the regulation of glucose metabolism in response to endotoxin by blocking NO synthesis with N(G)-monomethyl-L-arginine (L-NMMA). In five dogs, the appearance and disappearance rates of glucose (by infusion of [6,6-(2)H(2)]glucose), plasma glucose concentration, and plasma hormone concentrations were measured on five different occasions: saline infusion, endotoxin alone (E coli, 1.0 microg/kg i.v.), and endotoxin administration plus three different doses of primed, continuous infusion of L-NMMA. Endotoxin increased rate of appearance of glucose from 13.7 +/- 1.6 to 23.6 +/- 3.3 micromol x kg(-1) x min(-1) (P

Published
2001

50. The recurrence pattern of esophageal carcinoma after transhiatal resection

Author

Hulscher, J. B., van Sandick, J. W., Tijssen, J. G., Obertop, H., van Lanschot, J. J., and Other departments

Abstract

BACKGROUND: There is much controversy about the optimal resection for carcinoma of the esophagus. Little is known about the pattern of recurrence after transhiatal resection for esophageal carcinoma. STUDY DESIGN: We retrospectively reviewed the charts of 149 patients who underwent transhiatal esophagectomy for carcinoma of the mid or distal esophagus or gastroesophageal junction between June 1993 and June 1997. Recurrence was classified as locoregional or distant recurrence. Nine patients with macroscopically evident tumor left after resection and three patients (2.0%) who died in the hospital were excluded from the analysis. This left 137 patients; 105 men and 32 women with a median age 65 years (range 37 to 84 years). RESULTS: There were 95 adenocarcinomas (69.3%) and 42 squamous cell carcinomas (30.7%). Overall the median followup was 24.0 months (range 1.4 to 69.2 months). For patients alive at the end offollowup without recurrence, the median followup was 36.5 months (range 23.6 to 69.2 months). Seven patients died of other causes. The median interval between operation and recurrence was 11 months (range 1.4 to 62.5 months) for patients who had recurrence, with no significant difference in interval between locoregional and systemic recurrence. Seventy-two of the 137 patients (52.6%) developed recurrent disease. Thirty-two patients (23.4%) developed locoregional recurrence only, 21 patients (15.3%) developed systemic recurrence only, and 19 patients (13.9%) had a combination of both. In only 8.0% of all patients was there recurrence in the cervical lymph nodes. The most frequent sites of distant recurrence were liver (37.5%), bone (25.0%), and lung (17.5%). Recurrence was related to postoperative lymph node status (p

Published
2000

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