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2. The influence of anastomotic techniques on postoperative anastomotic complications: Results of the Oesophago-Gastric Anastomosis Audit

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., Mejía-Fernández, L., El Kafsi, J., Sayyed, R.H., Sousa, 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-Amézquita, 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., Bjelović, M., So, J.B.Y., Gačevski, G., Loureiro, C., Pera, M., Bianchi, A., Moreno Gijón, M., Martín Fernández, J., Trugeda Carrera, M.S., Vallve-Bernal, M., Cítores Pascual, M.A., Elmahi, S., Halldestam, I., Hedberg, J., Mönig, S., Gutknecht, S., Tez, M., Guner, A., Tirnaksiz, M.B., Colak, E., Sevinç, 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., Al-Bahrani, A., 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, V., Jr, 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., Beltrán-García, T.C., Castilla, L., Pineda, M., Bastidas, A., Gómez-Mayorga, J., Cortés, 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., Meriläinen, 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., Ó Súilleabháin, C.B., Hennessy, M.M., Ivanovski, I., Khizer, H., Ravi, N., Donlon, N., Cervellera, M., Vaccari, S., Bianchini, S., Sartarelli, l., 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., 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., Ho, C.A., Pang, W.S., Tan, J.H., Basave, H.N.L., Cortés-González, 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., Young, M., 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., MA, Noor, 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., Gunjić, D., Veselinović, M., Babič, T., Chin, T.S., Shabbir, A., Kim, G., Crnjac, A., Samo, H., Díez del Val, I., Leturio, S., Ramón, J.M., Dal Cero, M., Rifá, 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., García, S.S., Santos, E.P.G., Martínez, E.T., Fernández Díaz, M.J., Magadán Álvarez, C., Concepción Martín, V., Díaz López, C., Rosat Rodrigo, A., Pérez Sánchez, L.E., Bailón Cuadrado, M., Tinoco Carrasco, C., Choolani Bhojwani, E., Sánchez, D.P., Ahmed, M.E., Dzhendov, T., Lindberg, F., Rutegård, 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., Willem, J., Bouras, G., Evans, R., Singh, M., Warrilow, H., Ahmad, A., Tewari, N., Yanni, F., Couch, J., Theophilidou, E., Reilly, J.J., van Boxel Gijs, Akbari, K., Zanotti, D., Sgromo, B., 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., and Mitchell, J.D.

Published
2022
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3. Postoperative and Pathological Outcomes of CROSS and FLOT as Neoadjuvant Therapy for Esophageal and Junctional Adenocarcinoma: An International Cohort Study From the Oesophagogastric Anastomosis Audit (OGAA)

Author

Steering Committee, Alderson, D, Bundred, J, RPT, Evans, Gossage, J, Griffiths, EA, Jefferies, B, Kamarajah, SK, McKay, S, Mohamed, I, Nepogodiev, D, Siaw- Acheampong, K, Singh, P, van Hillegersberg, R, Vohra, R, Wanigasooriya, K, Whitehouse, T., National Leads, Gjata, A, Moreno, JI, Takeda, FR, Kidane, B, Guevara Castro, R, Harustiak, T, Bekele, A, Kechagias, A, Gockel, I, Kennedy, A, Da Roit, A, Bagajevas, A, Azagra, JS, Mahendran, HA, Mejía-Fernández, L, Wijnhoven, BPL, El Kafsi, J, Sayyed, RH, Sousa, M, Sampaio, AS, Negoi, I, Blanco, R, Wallner, B, Schneider, PM, Hsu, PK, Isik, A, Site Leads, Gananadha, S, Wills, V, Devadas, M, Duong, C, Talbot, M, Hii, MW, Jacobs, R, Andreollo, NA, Johnston, B, Darling, G, Isaza-Restrepo, A, Rosero, G, Arias- Amézquita, F, Raptis, D, Gaedcke, J, Reim, D, Izbicki, J, Egberts, JH, Dikinis, S, Kjaer, DW, Larsen, MH, Achiam, MP, Saarnio, J, Theodorou, D, Liakakos, T, Korkolis, DP, Robb, WB, Collins, C, Murphy, T, Reynolds, J, Tonini, V, Migliore, M, Bonavina, L, Valmasoni, M, Bardini, R, Weindelmayer, J, Terashima, M, White, RE, Alghunaim, E, Elhadi, M, Leon-Takahashi, AM, Medina-Franco, H, Lau, PC, Okonta, KE, Heisterkamp, J, Rosman, C, van Hillegersberg, R, Beban, G, Babor, R, Gordon, A, Rossaak, JI, Pal, KMI, Qureshi, AU, Naqi, SA, Syed, AA, Barbosa, J, Vicente, CS, Leite, J, Freire, J, Casaca, R, Costa, RCT, Scurtu, RR, Mogoanta, SS, Bolca, C, Constantinoiu, S, Sekhniaidze, D, Bjelović, M, So, JBY, Gačevski, G, Loureiro, C, Pera, M, Bianchi, A, Moreno Gijón, M, Martín Fernández, J, Trugeda Carrera, MS, Vallve-Bernal, M, Cítores Pascual, MA, Elmahi, S, Halldestam, I, Hedberg, J, Mönig, S, Gutknecht, S, Tez, M, Guner, A, Tirnaksiz, MB, Colak, E, Sevinç, 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, Gossage, J, Nijjar, R, Viswanath, YKS, Turner, P, Dexter, S, Boddy, A, Allum, WH, Oglesby, S, Cheong, E, Beardsmore, D, Vohra, R, Maynard, N, Berrisford, R, Mercer, S, Puig, S, Melhado, R, Kelty, C, Underwood, T, Dawas, K, Lewis, W, Al-Bahrani, A, Bryce, G, Thomas, M, Arndt, AT, Palazzo, F, Meguid, RA, Collaborators, Fergusson, J, Beenen, E, Mosse, C, Salim, J, Cheah, S, Wright, T, Cerdeira, MP, McQuillan, P, Richardson, M, Liem, H, Spillane, J, Yacob, M, Albadawi, F, Thorpe, T, Dingle, A, Cabalag, C, Loi, K, Fisher, OM, Ward, S, Read, M, Johnson, M, Bassari, R, Bui, H, Cecconello, I, RAA, Sallum, da Rocha, JRM, Lopes, LR, Tercioti, V, Jr, JDS, Coelho, Ferrer, JAP, Buduhan, G, Tan, L, Srinathan, S, Shea, P, Yeung, J, Allison, F, Carroll, P, Vargas-Barato, F, Gonzalez, F, Ortega, J, Nino-Torres, L, Beltrán-García, TC, Castilla, L, Pineda, M, Bastidas, A, Gómez-Mayorga, J, Cortés, N, Cetares, C, Caceres, S, Duarte, S, Pazdro, A, Snajdauf, M, Faltova, H, Sevcikova, M, Mortensen, PB, Katballe, N, Ingemann, T, Kruhlikava, Morten B, I, Ainswort, AP, Stilling, NM, Eckardt, J, Holm, J, Thorsteinsson, M, Siemsen, M, Brandt, B, Nega, B, Teferra, E, Tizazu, A, Kauppila, JH, Koivukangas, V, Meriläinen, 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, DK, Balalis, D, Bolger, J, Baban, C, Mastrosimone, A, McAnena, O, Quinn, A, Ó Súilleabháin, CB, Hennessy, MM, Ivanovski, I, Khizer, H, Ravi, N, Donlon, N, Cervellera, M, Vaccari, S, Bianchini, S, Sartarelli, l, Asti, E, Bernardi, D, Merigliano, S, Provenzano, L, Scarpa, M, Saadeh, L, Salmaso, B, De Manzoni, G, Giacopuzzi, S, La Mendola, R, De Pasqual, CA, Tsubosa, Y, Niihara, M, Irino, T, Makuuchi, R, Ishii, K, Mwachiro, M, Fekadu, A, Odera, A, Mwachiro, E, AlShehab, D, Ahmed, HA, Shebani, AO, Elhadi, A, Elnagar, FA, Elnagar, HF, Makkai-Popa, ST, Wong, LF, Tan, YR, Thannimalai, S, Ho, CA, Pang, WS, Tan, JH, HNL, Basave, Cortés-González, R, Lagarde, SM, van Lanschot, JJB, Cords, C, Jansen, WA, Martijnse, I, Matthijsen, R, Bouwense, S, Klarenbeek, B, Verstegen, M, van Workum, F, Ruurda, JP, van der Sluis, PC, de Maat, M, Evenett, N, Johnston, P, Patel, R, MacCormick, A, Young, M, Smith, B, Ekwunife, C, Memon, AH, Shaikh, K, Wajid, A, Khalil, N, Haris, M, Mirza, ZU, SBA, Qudus, Sarwar, MZ, Shehzadi, A, Raza, A, Jhanzaib, MH, Farmanali, J, Zakir, Z, Shakeel, O, Nasir, I, Khattak, S, Baig, M, Noor, MA, Ahmed, HH, Naeem, A, Pinho, AC, da Silva, R, Bernardes, A, Campos, JC, Matos, H, Braga, T, Monteiro, C, Ramos, P, Cabral, F, Gomes, MP, Martins, PC, Correia, AM, Videira, JF, Ciuce, C, Drasovean, R, Apostu, R, Ciuce, C, Paitici, S, Racu, AE, Obleaga, CV, Beuran, M, Stoica, B, Negoita, Ciubotaru C, V, Cordos, I, Birla, RD, Predescu, D, Hoara, PA, Tomsa, R, Shneider, V, Agasiev, M, Ganjara, I, Gunjić, D, Veselinović, M, Babič, T, Chin, TS, Shabbir, A, Kim, G, Crnjac, A, Samo, H, Díez del Val, I, Leturio, S, Ramón, JM, Dal Cero, M, Rifá, S, Rico, M, Pagan Pomar, A, Martinez Corcoles, JA, Rodicio Miravalles, JL, Pais, SA, Turienzo, SA, Alvarez, LS, Campos, PV, Rendo, AG, García, SS, EPG, Santos, Martínez, ET, Fernández Díaz, MJ, Magadán Álvarez, C, Concepción Martín, V, Díaz López, C, Rosat Rodrigo, A, Pérez Sánchez, LE, Bailón Cuadrado, M, Tinoco Carrasco, C, Choolani Bhojwani, E, Sánchez, DP, Ahmed, ME, Dzhendov, T, Lindberg, F, Rutegård, M, Sundbom, M, Mickael, C, Colucci, N, Schnider, A, Er, S, Kurnaz, E, Turkyilmaz, S, Turkyilmaz, A, Yildirim, R, Baki, BE, 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, TH, 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, LC, 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, McKay, S, 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, Willem, J, Bouras, G, Evans, R, Singh, M, Warrilow, H, Ahmad, A, Tewari, N, Yanni, F, Couch, J, Theophilidou, E, Reilly, JJ, Singh, P, van Boxel, Gijs, Akbari, K, Zanotti, D, Sgromo, B, Sanders, G, Wheatley, T, Ariyarathenam, A, Reece-Smith, A, Humphreys, L, Choh, C, Carter, N, Knight, B, Pucher, P, Athanasiou, A, Mohamed, I, Tan, B, Abdulrahman, M, Vickers, J, Akhtar, K, Chaparala, R, Brown, R, Alasmar, MMA, 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, IA, Karush, MK, Seder, CW, Liptay, MJ, Chmielewski, G, Rosato, EL, Berger, AC, Zheng, R, Okolo, E, Singh, A, Scott, CD, Weyant, MJ, and Mitchell, JD.

Published
2023
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6. Postoperative outcomes in oesophagectomy with trainee involvement

Author

R P, T Evans, K Kamarajah, S, Bundred, J, Nepogodiev, D, Hodson, J, R van Hillegersberg, Gossage, J, Vohra, R, A Griffiths, E, Singh, P, Alderson, D, Jefferies, B, Mckay, S, Mohamed, I, K Siaw- Acheampong, Wanigasooriya, K, Whitehouse, T, Gjata, A, I Moreno, J, R Takeda, F, Kidane, B, R Guevara Castro, Harustiak, T, Bekele, A, Kechagias, A, Gockel, I, Kennedy, A, A Da Roit, Bagajevas, A, S Azagra, J, A Mahendran, H, Mej??a-Fern??ndez, L, B P, L Wijnhoven, J El Kafsi, H Sayyed, R, Sousa, M, S Sampaio, A, Negoi, I, Blanco, R, Wallner, B, M Schneider, P, K Hsu, P, Isik, A, Gananadha, S, Wills, V, Devadas, M, Duong, C, Talbot, M, W Hii, M, Jacobs, R, A Andreollo, N, Johnston, B, Darling, G, Isaza-Restrepo, A, Rosero, G, Arias-Am??zquita, F, Raptis, D, Gaedcke, J, Reim, D, Izbicki, J, H Egberts, J, Dikinis, S, W Kjaer, D, H Larsen, M, P Achiam, M, Saarnio, J, Theodorou, D, Liakakos, T, P Korkolis, D, B Robb, W, Collins, C, Murphy, T, Reynolds, J, Tonini, V, Migliore, M, Bonavina, L, Valmasoni, M, Bardini, R, Weindelmayer, J, Terashima, M, E White, R, Alghunaim, E, Elhadi, M, M Leon-Takahashi, A, Medina-Franco, H, C Lau, P, E Okonta, K, Heisterkamp, J, Rosman, C, Beban, G, Babor, R, Gordon, A, I Rossaak, J, K M, I Pal, U Qureshi, A, A Naqi, S, A Syed, A, Barbosa, J, S Vicente, C, Leite, J, Freire, J, Casaca, R, R C, T Costa, R Scurtu, R, S Mogoanta, S, Bolca, C, Constantinoiu, S, Sekhniaidze, D, Bjelovi??, M, J B, Y So, Ga??evski, G, Loureiro, C, Pera, M, Bianchi, A, M Moreno Gij??n, J Mart??n Fern??ndez, S Trugeda Carrera, M, Vallve-Bernal, M, A C??tores Pascual, M, Elmahi, S, Hedberg, J, M??nig, S, Gutknecht, S, Tez, M, Guner, A, B Tirnaksiz, T, 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, Y K, S Viswanath, Turner, P, Dexter, S, Boddy, A, H Allum, W, Oglesby, S, Cheong, E, Beardsmore, D, Maynard, N, Berrisford, R, Mercer, S, Puig, S, Melhado, R, Kelty, C, Underwood, T, Dawas, K, Lewis, W, Al-Bahrani, A, Bryce, G, Thomas, M, T Arndt, A, Palazzo, F, A Meguid, R, Fergusson, J, Beenen, E, Mosse, C, Salim, J, Cheah, S, Wright, T, P Cerdeira, M, Mcquillan, P, Richardson, M, Liem, H, Spillane, J, Yacob, M, Albadawi, F, Thorpe, T, Dingle, A, Cabalag, C, Loi, K, M Fisher, O, Ward, S, Read, M, Johnson, M, Bassari, R, Bui, H, Cecconello, I, R A, A Sallum, J R, M da Rocha, R Lopes, L, Tercioti, V, J D, S Coelho, J A, P Ferrer, Buduhan, G, Tan, L, Srinathan, S, Shea, P, Yeung, J, Allison, F, Carroll, P, Vargas-Barato, F, Gonzalez, F, Ortega, J, Nino-Torres, L, C Beltr??n-Garc??a, T, 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, B Mortensen, P, Katballe, N, Ingemann, T, Morten, B, Kruhlikava, I, P Ainswort, A, M Stilling, N, Eckardt, J, Holm, J, Thorsteinsson, M, Siemsen, M, Brandt, B, Nega, B, Teferra, E, Tizazu, A, S Kauppila, J, 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, Baili, E, Mpoura, M, Charalabopoulos, A, K Manatakis, D, Balalis, D, Bolger, J, Baban, C, Mastrosimone, A, Mcanena, O, Quinn, A, B ?? S??illeabh??in, C, M Hennessy, M, Ivanovski, I, Khizer, H, Ravi, N, Donlon, N, Cervellera, M, Vaccari, S, Bianchini, S, Sartarelli, L, Asti, E, Bernardi, D, Merigliano, S, Provenzano, L, Scarpa, M, Saadeh, L, Salmaso, B, DE MANZONI, Giovanni, Giacopuzzi, S, R La Mendola, A De Pasqual, C, Tsubosa, Y, Niihara, M, Irino, T, Makuuchi, R, Ishii, K, Mwachiro, M, Fekadu, A, Odera, A, Mwachiro, E, Alshehab, D, A Ahmed, H, O Shebani, A, Elhadi, A, A Elnagar, F, F Elnagar, H, T Makkai-Popa, S, F Wong, L, Yunrong, T, Thanninalai, S, C Aik, H, W Soon, P, J Huei, T, H N, L Basave, Cort??s-Gonz??lez, R, M Lagarde, S, J J, B van Lanschot, Cords, C, A Jansen, W, Martijnse, I, Matthijsen, R, Bouwense, S, Klarenbeek, B, Verstegen, M, F van Workum, P Ruurda, J, A van der Veen, W van den Berg, J, Evenett, N, Johnston, P, Patel, R, Maccormick, A, Young, M, Smith, B, Ekwunife, C, H Memon, A, Shaikh, K, Wajid, A, Khalil, N, Haris, M, U Mirza, Z, S B, A Qudus, Z Sarwar, M, Shehzadi, A, Raza, A, H Jhanzaib, M, Farmanali, J, Zakir, Z, Shakeel, O, Nasir, I, Khattak, S, Baig, M, A Noor, M, H Ahmed, H, Naeem, A, C Pinho, A, R da Silva, Matos, H, Braga, T, Monteiro, C, Ramos, P, Cabral, F, P Gomes, M, C Martins, P, M Correia, A, F Videira, J, Ciuce, C, Drasovean, R, Apostu, R, Paitici, S, E Racu, A, V Obleaga, C, Beuran, M, Stoica, B, Ciubotaru, C, Negoita, V, Cordos, I, D Birla, R, Predescu, D, A Hoara, P, Tomsa, R, Shneider, V, Agasiev, M, Ganjara, I, Gunji??, D, Veselinovi??, M, Babi??, T, S Chin, T, Shabbir, A, Kim, G, Crnjac, A, Samo, H, I D??ez del Val, Leturio, S, M Ram??n, J, M Dal Cero, Rif??, S, Rico, M, A Pagan Pomar, A Martinez Corcoles, J, L Rodicio Miravalles, J, A Pais, S, A Turienzo, S, S Alvarez, L, V Campos, P, G Rendo, A, S Garc??a, S, E P, G Santos, T Mart??nez, E, J Fern??ndez D??az, M, C Magad??n ??lvarez, V Concepci??n Mart??n, C D??az L??pez, A Rosat Rodrigo, E P??rez S??nchez, L, M Bail??n Cuadrado, C Tinoco Carrasco, E Choolani Bhojwani, P S??nchez, D, E Ahmed, M, Dzhendov, T, Lindberg, F, Ruteg??rd, M, Sundbom, M, Mickael, C, Colucci, N, Schnider, A, S, Er, Kurnaz, E, Turkyilmaz, S, Turkyilmaz, A, Yildirim, R, E Baki, B, 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, H Wiggins, T, 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, C Tan, L, Mclaughlin, E, Koshy, R, Sharp, C, Brewer, H, Das, N, Cox, M, W Al Khyatt, 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, F Di Maggio, 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, H Sue Ling, Mehta, S, Hayden, J, N, To, 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, Willem, J, Bouras, G, Evans, R, Singh, M, Warrilow, H, Ahmad, A, Tewari, N, Yanni, F, Couch, J, Theophilidou, E, J Reilly, J, G van Boxel, Akbari, K, Zanotti, D, Sgromo, B, 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, M M, A Alasmar, 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, A Makey, I, K Karush, M, W Seder, C, J Liptay, M, Chmielewski, G, L Rosato, E, C Berger, A, Zheng, R, Okolo, E, Singh, A, D Scott, C, J Weyant, M, D Mitchell, J, Surgery, Evans, RPT, Hodson, J, Kamarajah, SK, Griffiths, EA, Singh, P, Alderson, D, Bundred, J, Gossage, J, Jefferies, B, McKay, S, Mohamed, I, Nepogodiev, D, Siaw-Acheampong, K, van Hillegersberg, R, Vohra, R, Wanigasooriya, K, Whitehouse, T, Gjata, A, Moreno, JI, Takeda, FR, Kidane, B, Castro, RG, Harustiak, T, Bekele, A, Kechagias, A, Gockel, I, Kennedy, A, Da Roit, A, Bagajevas, A, Azagra, JS, Mahendran, HA, Mejia-Fernandez, L, Wijnhoven, BPL, El Kafsi, J, Sayyed, RH, Sousa, M, Sampaio, AS, Negoi, I, Blanco, R, Wallner, B, Schneider, PM, Hsu, PK, Isik, A, Gananadha, S, Wills, V, Devadas, M, Duong, C, Talbot, M, Hii, MW, Jacobs, R, Andreollo, NA, Johnston, B, Darling, G, Isaza-Restrepo, A, Rosero, G, Arias-Amezquita, F, Raptis, D, Gaedcke, J, Reim, D, Izbicki, J, Egberts, JH, Dikinis, S, Kjaer, DW, Larsen, MH, Achiam, MP, Saarnio, J, Theodorou, D, Liakakos, T, Korkolis, DP, Robb, WB, Collins, C, Murphy, T, Reynolds, J, Tonini, V, Migliore, M, Bonavina, L, Valmasoni, M, Bardini, R, Weindelmayer, J, Terashima, M, White, RE, Alghunaim, E, Elhadi, M, Leon-Takahashi, AM, Medina-Franco, H, Lau, PC, Okonta, KE, Heisterkamp, J, Rosman, C, Beban, G, Babor, R, Gordon, A, Rossaak, JI, Pal, KMI, Qureshi, AU, Naqi, SA, Syed, AA, Barbosa, J, Vicente, CS, Leite, J, Freire, J, Casaca, R, Costa, RCT, Scurtu, RR, Mogoanta, SS, Bolca, C, Constantinoiu, S, Sekhniaidze, D, So, JBY, Gacvski, G, Loureiro, C, Pera, M, Bianchi, A, Gijon, MM, Fernandez, JM, Carrera, MST, Vallve-Bernal, M, Pascual, MAC, Elmahi, S, Halldestam, I, Hedberg, J, Monig, S, Gutknecht, S, Tez, M, Guner, A, Tirnaksiz, TB, Colak, E, Sevinc, 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, YKS, Turner, P, Dexter, S, Boddy, A, Allum, WH, Oglesby, S, Cheong, E, Beardsmore, D, Maynard, N, Berrisford, R, Mercer, S, Puig, S, Melhado, R, Kelty, C, Underwood, T, Dawas, K, Lewis, W, Al-Bahrani, A, Bryce, G, Thomas, M, Arndt, AT, Palazzo, F, Meguid, RA, Fergusson, J, Beenen, E, Mosse, C, Salim, J, Cheah, S, Wright, T, Cerdeira, MP, McQuillan, P, Richardson, M, Liem, H, Spillane, J, Yacob, M, Albadawi, F, Thorpe, T, Dingle, A, Cabalag, C, Loi, K, Fisher, OM, Ward, S, Read, M, Johnson, M, Bassari, R, Bui, H, Cecconello, I, Sallum, RAA, da Rocha, JRM, Lopes, LR, Tercioti, V, Coelho, JDS, Ferrer, JAP, 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, TC, Castilla, L, Pineda, M, Bastidas, A, Gomez-Mayorga, J, Cortes, N, Cetares, C, Caceres, S, Duarte, S, Pazdro, A, Snajdauf, M, Faltova, H, Sevcikova, M, Mortensen, PB, Katballe, N, Ingemann, T, Morten, B, Kruhlikava, I, Ainswort, AP, Stilling, NM, Eckardt, J, Holm, J, Thorsteinsson, M, Siemsen, M, Brandt, B, Nega, B, Teferra, E, Tizazu, A, Kauppila, JS, Koivukangas, V, Merilainen, 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, Baili, E, Mpoura, M, Charalabopoulos, A, Manatakis, DK, Balalis, D, Bolger, J, Baban, C, Mastrosimone, A, McAnena, O, Quinn, A, Suilleabhain, CBO, Hennessy, MM, Ivanovski, I, Khizer, H, Ravi, N, Donlon, N, Cervellera, M, Vaccari, S, Bianchini, S, Sartarelli, L, Asti, E, Bernardi, D, Merigliano, S, Provenzano, L, Scarpa, M, Saadeh, L, Salmaso, B, De Manzoni, G, Giacopuzzi, S, La Mendola, R, De Pasqual, CA, Tsubosa, Y, Niihara, M, Irino, T, Makuuchi, R, Ishii, K, Mwachiro, M, Fekadu, A, Odera, A, Mwachiro, E, AlShehab, D, Ahmed, HA, Shebani, AO, Elhadi, A, Elnagar, FA, Elnagar, HF, Makkai-Popa, ST, Wong, LF, Yunrong, T, Thanninalai, S, Aik, HC, Soon, PW, Huei, TJ, Basave, HNL, Cortes-Gonzalez, R, Lagarde, SM, van Lanschot, JJB, Cords, C, Jansen, WA, Martijnse, I, Matthijsen, R, Bouwense, S, Klarenbeek, B, Verstegen, M, van Workum, F, Ruurda, JP, van der Veen, A, van den Berg, JW, Evenett, N, Johnston, P, Patel, R, MacCormick, A, Young, M, Smith, B, Ekwunife, C, Memon, AH, Shaikh, K, Wajid, A, Khalil, N, Haris, M, Mirza, ZU, Qudus, SBA, Sarwar, MZ, Shehzadi, A, Raza, A, Jhanzaib, MH, Farmanali, J, Zakir, Z, Shakeel, O, Nasir, I, Khattak, S, Baig, M, Noor, MA, Ahmed, HH, Naeem, A, Pinho, AC, da Silva, R, Bernardes, A, Campos, JC, Matos, H, Braga, T, Monteiro, C, Ramos, P, Cabral, F, Gomes, MP, Martins, PC, Correia, AM, Videira, JF, Ciuce, C, Drasovean, R, Apostu, R, Paitici, S, Racu, AE, Obleaga, CV, Beuran, M, Stoica, B, Ciubotaru, C, Negoita, V, Cordos, I, Birla, RD, Predescu, D, Hoara, PA, Tomsa, R, Shneider, V, Agasiev, M, Ganjara, I, Gunjic, D, Veselinovic, M, Babic, T, Chin, TS, Shabbir, A, Kim, G, Crnjac, A, Samo, H, del Val, ID, Leturio, S, Ramon, JM, Dal Cero, M, Rifa, S, Rico, M, Pomar, AP, Corcoles, JAM, Miravalles, JLR, Pais, SA, Turienzo, SA, Alvarez, LS, Campos, PV, Rendo, AG, Garcia, SS, Santos, EPG, Martinez, ET, Diaz, MJF, Alvarez, CM, Martin, VC, Lopez, CD, Rodrigo, AR, Sanchez, LEP, Cuadrado, MB, Carrasco, CT, Bhojwani, EC, Sanchez, DP, Ahmed, ME, Dzhendov, T, Lindberg, F, Rutegard, M, Sundbom, M, Mickael, C, Colucci, N, Schnider, A, Er, S, Kurnaz, E, Turkyilmaz, S, Turkyilmaz, A, Yildirim, R, Baki, BE, 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, TH, 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, LC, 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, Ling, HS, Mehta, S, Hayden, J, To, N, Palser, T, Hunter, D, Supramaniam, K, Butt, Z, Ahmed, A, Kumar, S, Chaudry, A, Moussa, O, Kordzadeh, A, Patil, P, Noaman, I, Willem, J, Bouras, G, Evans, R, Singh, M, Warrilow, H, Ahmad, A, Tewari, N, Yanni, F, Couch, J, Theophilidou, E, Reilly, JJ, van Boxel, G, Akbari, K, Zanotti, D, Sgromo, B, 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, MMA, 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, IA, Karush, MK, Seder, CW, Liptay, MJ, Chmielewski, G, Rosato, EL, Berger, AC, Zheng, R, Okolo, E, Singh, A, Scott, CD, Weyant, MJ, and Mitchell, JD

Subjects
squamous cell carcinoma, surgical mortality, AcademicSubjects/MED00910, Esophageal Neoplasms, SURGERY, IMPACT, clinical outcome, Anastomotic Leak, Adult, aged, anastomosis leakage, article, cancer staging, cardiovascular disease assessment, Charlson Comorbidity Index, cohort analysis, ECOG Performance Status, esophagectomy, esophagus cancer, female, follow up, histology, human, intensive care unit, length of stay, major clinical study, male, middle aged, mortality, necrosis, neoadjuvant chemoradiotherapy, neoadjuvant chemotherapy, observational study, postoperative complication, postoperative period, reoperation, surgical technique, Cohort Studies, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], Surgical, Anastomosis, Surgical, General Medicine, Original Article, AcademicSubjects/MED00010, Life Sciences & Biomedicine, Anastomosis, SOCIETY, Bjs/5, trainee, oesophagectomy, trainee, Humans, Esophagectomy, All institutes and research themes of the Radboud University Medical Center, SDG 3 - Good Health and Well-being, RESIDENT INVOLVEMENT, Science & Technology, SURGICAL OUTCOMES
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
2022
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9. 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
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13. 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

14. 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

15. Implantable Cardiac Monitoring in the Secondary Prevention of Cryptogenic Stroke

Author

Triantafyllou, S. Katsanos, A.H. Dilaveris, P. Giannopoulos, G. Kossyvakis, C. Adreanides, E. Liantinioti, C. Tympas, K. Zompola, C. Theodorou, A. Palaiodimou, L. Flevari, P. Kosmidou, M. Voumvourakis, K. Parissis, J. Deftereos, S. Tsivgoulis, G.

Subjects
cardiovascular diseases
Abstract

Objective: In this study, we sought to evaluate the impact of implantable cardiac monitoring (ICM) in the prevention of stroke recurrence after a cryptogenic ischemic stroke or transient ischemic attack (TIA). Methods: We evaluated consecutive patients with cryptogenic ischemic stroke or TIA admitted in a comprehensive stroke center during an 8-year period. We compared the baseline characteristics and outcomes between patients receiving conventional cardiac monitoring with repeated 24-hour Holter-monitoring during the first 5 years in the outpatient setting and those receiving continuous cardiac monitoring with ICM during the last 3 years. Associations on the outcomes of interest were further assessed in multivariable regression models adjusting for potential confounders. Results: We identified a total of 373 patients receiving conventional cardiac monitoring and 123 patients receiving ICM. Paroxysmal atrial fibrillation (PAF) detection was higher in the ICM cohort compared to the conventional cardiac monitoring cohort (21.1% vs 7.5%, p < 0.001). ICM was independently associated with an increased likelihood of PAF detection during follow-up (hazard ratio [HR] = 1.94, 95% confidence interval [CI] = 1.16–3.24) in multivariable analyses. Patients receiving ICM were also found to have significantly higher rates of anticoagulation initiation (18.7% vs 6.4%, p < 0.001) and lower risk of stroke recurrence (4.1% vs 11.8%, p = 0.013). ICM was independently associated with a lower risk of stroke recurrence during follow-up (HR = 0.32, 95% CI = 0.11–0.90) in multivariable analyses. Interpretation: ICM appears to be independently associated with a higher likelihood of PAF detection and anticoagulation initiation after a cryptogenic ischemic stroke or TIA. ICM was also independently related to lower risk of stroke recurrence in our cryptogenic stroke / TIA cohort. ANN NEUROL 2020;88:946–955. © 2020 American Neurological Association

Published
2020

17. Risk of perioperative neck hematoma in TIA and non-disabling stroke patients with symptomatic carotid artery stenosis undergoing endarterectomy within 14 days from cerebrovascular event

Author

Roussopoulou, A. Lazaris, A. Tsivgoulis, G. Krogias, C. Moulakakis, K. Georgiadis, G.S. Kakisis, J.D. Zompola, C. Faissner, S. Palaiodimou, L. Theodorou, A. Hummel, T. Safouris, A. Matsota, P. Zervas, P. Triantafyllou, S. Voumvourakis, C. Lazarides, M. Geroulakos, G. Vasdekis, S.N.

Subjects
hemic and lymphatic diseases
Abstract

Backround & purpose: Perioperative neck hematoma (PNH) requiring re-intervention is an important complication after carotid endarterectomy (CEA). There are limited data regarding the potential risk factors associated with PNH. The aim of this prospective, multicenter study was to document the rate of PNH in symptomatic carotid artery stenosis (sCAS) patients treated with CEA within the first 14 days of cerebrovascular symptom onset and to identify possible predictors of this complication. Methods: Patients with non-disabling (mRS ≤ 2) acute ischemic stroke or transient ischemic attack due to sCAS (≥70%) underwent CEA at three stroke-centers during a seven-year period. PNH requiring surgical re-intervention or transfusion during a 30-day follow-up period was determined by the attending surgeon but was also confirmed by an independent neurologist. Results: A total of 280 patients with sCAS underwent CEA within 14 days of ictus. PNH occurred in 10 cases (3.6%; 95%CI: 1.4%–5.8%). Pretreatment with therapeutic anticoagulation (TA) and history of atrial fibrillation were more prevalent in patients with PNH (20% vs. 3.1%, p= 0.047 & 30% vs. 8.2%, p = 0.05 respectively). Elapsed time between symptom onset and carotid surgery, pretreatment with dual antiplatelets, intravenous thrombolysis or prophylactic anticoagulation were not related to PNH in univariable analyses. Pretreatment with TA was independently associated with higher likelihood of PNH [OR: 10.69, 95%CI (1.74–65.72), p = 0.011] in multivariate logistic regression models adjusting for potential confounders. Conclusion: PNH is uncommon in patients with sCAS that are operated during the first 14 days of ictus. Pretreatment with TA appears to be associated with higher risk of PNH. © 2019 Elsevier B.V.

Published
2020

18. Endoscopic Treatment of Anastomotic Leak after Esophagectomy and Gastrectomy.

Author

Katsila, S., Triantafyllou, A., Kakounis, K., Triantafyllou, S., Dimopoulou, K., Theodorou, D., and Xiromeritou, V.

Subjects
GASTRECTOMY, ESOPHAGECTOMY, ENDOSCOPIC surgery, BARIATRIC surgery, ESOPHAGUS diseases
Abstract

This article, published in the journal Endoscopy, presents cases and endoscopic treatment of anastomotic leaks after esophagectomy and gastrectomy. The study retrospectively recorded cases of leaks during the period of 2022-2023, with a total of 32 patients undergoing Ivor Lewis esophagectomy, 34 patients undergoing McKeown esophagectomy, and various other procedures. Anastomotic leakage was observed in 24 patients, and different treatment methods were used, including fully covered esophageal stent placement and endoscopic placement. The median time for leakage healing was 31 days, and the success rate was approximately 92.8%. The article concludes that the management of anastomotic leakage is complex and highlights the importance of gastroenterologists in its treatment. [Extracted from the article]

Published
2024
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25. Potential utility of neurosonology in paroxysmal atrial fibrillation detection in patients with cryptogenic stroke

Author

Liantinioti, C. Palaiodimou, L. Tympas, K. Parissis, J. Theodorou, A. Ikonomidis, I. Chondrogianni, M. Zompola, C. Triantafyllou, S. Roussopoulou, A. Kargiotis, O. Serdari, A. Bonakis, A. Vadikolias, K. Voumvourakis, K. Stefanis, L. Filippatos, G. Tsivgoulis, G.

Subjects
cardiovascular system, cardiovascular diseases
Abstract

Background: Occult paroxysmal atrial fibrillation (PAF) is a common and potential treatable cause of cryptogenic stroke (CS). We sought to prospectively identify independent predictors of atrial fibrillation (AF) detection in patients with CS and sinus rhythm on baseline electrocardiogram (ECG), without prior AF history. We had hypothesized that cardiac arrhythmia detection during neurosonology examinations (Carotid Duplex (CDU) and Transcranial Doppler (TCD)) may be associated with higher likelihood of AF detection. Methods: Consecutive CS patients were prospectively evaluated over a six-year period. Demographics, clinical and imaging characteristics of cerebral ischemia were documented. The presence of arrhythmia during spectral waveform analysis of CDU/TCD was recorded. Left atrial enlargement was documented during echocardiography using standard definitions. The outcome event of interest included PAF detection on outpatient 24-h Holter ECG recordings. Statistical analyses were performed using univariate and multivariate logistic regression models. Results: A total of 373 patients with CS were evaluated (mean age 60 ± 11 years, 67% men, median NIHSS-score 4 points). The rate of PAF detection of any duration on Holter ECG recordings was 11% (95% CI 8%–14%). The following three variables were independently associated with the likelihood of AF detection on 24-h Holter-ECG recordings in both multivariate analyses adjusting for potential confounders: age (OR per 10-year increase: 1.68; 95% CI: 1.19–2.37; p = 0.003), moderate or severe left atrial enlargement (OR: 4.81; 95% CI: 1.77–13.03; p = 0.002) and arrhythmia detection during neurosonology evaluations (OR: 3.09; 95% CI: 1.47–6.48; p = 0.003). Conclusion: Our findings underline the potential utility of neurosonology in improving the detection rate of PAF in patients with CS. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.

Published
2019

26. Clinical and Neuroimaging Characteristics in Embolic Stroke of Undetermined versus Cardioembolic Origin: A Population-Based Study

Author

Tsivgoulis, G. Kargiotis, O. Katsanos, A.H. Patousi, A. Pikilidou, M. Birbilis, T. Mantatzis, M. Palaiodimou, L. Triantafyllou, S. Papanas, N. Skendros, P. Terzoudi, A. Georgiadis, G.S. Maltezos, E. Piperidou, C. Serdari, A. Theodorou, A. Ikonomidis, I. Heliopoulos, I. Vadikolias, K.

Abstract

BACKGROUND AND PURPOSE: Evidence suggests that cardioembolism represents the underlying mechanism in the minority of embolic strokes of undetermined source (ESUS). In this population-based study, we sought to compare the clinical and imaging characteristics as well as outcomes in patients with ESUS and cardioembolic stroke (CE). METHODS: We included consecutive patients with first-ever ischemic stroke (IS) from the previously published population-based Evros-Stroke-Registry identified as ESUS or CE according to standardized criteria. Baseline characteristics, admission NIHSS scores, cerebral edema, hemorrhagic transformation, stroke recurrence, functional outcomes (determined by modified Rankin Scale [mRS] scores), and mortality rates were recorded during the 1-year follow-up period. RESULTS: We identified 21 ESUS (3.7% of IS) and 211 CE (37.1% of IS) cases. Patients with ESUS were younger (median age: 68 years [interquartile range [IQR]: 61-75] vs 80 years [IQR: 75-84]; P

Published
2019

27. Duration of implantable cardiac monitoring and detection of atrial fibrillation in ischemic stroke patients: A systematic review and meta-analysis

Author

Tsivgoulis, G. Katsanos, A.H. Köhrmann, M. Caso, V. Perren, F. Palaiodimou, L. Deftereos, S. Giannopoulos, S. Ellul, J. Krogias, C. Mavridis, D. Triantafyllou, S. Alexandrov, A.W. Schellinger, P.D. Alexandrov, A.V.

Abstract

Background and Purpose Current guidelines do not provide firm directions on atrial fibrillation (AF) screening after ischemic stroke (IS). We sought to investigate the association of implantable cardiac monitoring (ICM) duration with the yield of AF detection in IS patients. Methods We included studies reporting AF detection rates by ICM in IS patients with negative initial AF screening. We excluded studies reporting prolonged cardiac monitoring with devices other than ICM, not providing AF detection rates or monitoring duration, and reporting overlapping data for the same population. The random-effects model was used for all pooled estimates and meta-regression analyses. Results We included 28 studies (4,531 patients, mean age 65 years). In meta-regression analyses, the proportion of AF detection by ICM was independently associated with monitoring duration (coefficient=0.015; 95% confidence interval [CI], 0.005 to 0.024) and mean patient age (coefficient=0.009; 95% CI, 0.003 to 0.015). No associations were detected with other patient characteristics, including IS subtype (cryptogenic vs. embolic stroke of undetermined source) or time from IS onset to CM implantation. In subgroup analyses, significant differences (P12 and ≤24 months: 26% [95% CI, 22% to 31%]; >24 months: 34% [95% CI, 29% to 39%]). Conclusions Extended duration of ICM monitoring and increased patient age are factors that substantially increase AF detection in IS patients with initial negative AF screening. © 2019 Korean Stroke Society.

Published
2019

28. Incidence, characteristics and outcomes in patients with embolic stroke of undetermined source: A population-based study

Author

Tsivgoulis, G. Kargiotis, O. Katsanos, A.H. Patousi, A. Mavridis, D. Tsokani, S. Pikilidou, M. Birbilis, T. Mantatzis, M. Zompola, C. Triantafyllou, S. Papanas, N. Skendros, P. Terzoudi, A. Georgiadis, G.S. Maltezos, E. Piperidou, C. Tsioufis, K. Heliopoulos, I. Vadikolias, K.

Abstract

Embolic stroke of undetermined source (ESUS) represents a subgroup of cryptogenic ischemic stroke (CS) distinguished by high probability of an underlying embolic mechanism. There are scarce population-based data regarding the incidence, characteristics and outcomes of ESUS. Consecutive patients included with first-ever ischemic stroke of undetermined cause in the previously published population-based Evros Stroke Registry were further subdivided into ESUS and non-ESUS CS. Crude and adjusted [according to the European Standard Population (ESP), WHO and Segi population] incidence rates (IR) for ESUS and non-ESUS CS were calculated. Baseline characteristics, admission stroke severity (assessed using NIHSS-score), stroke recurrence and functional outcomes [determined by modified Rankin Scale (mRS) scores], were recorded during the 1-year follow-up period. We identified 21 and 242 cases with ESUS (8% of CS) and non-ESUS CS. The crude and ESP-adjusted IR for ESUS were 17.5 (95%CI: 10–25) and 16.6 (95%CI: 10–24) per 100,000 person-years. Patients with ESUS were younger (p

Published
2019

29. Stroke recurrence and mortality in northeastern Greece: the Evros Stroke Registry

Author

Tsivgoulis, G. Katsanos, A.H. Patousi, A. Pikilidou, M. Birbilis, T. Mantatzis, M. Yavropoulou, M. Zompola, C. Triantafyllou, S. Papanas, N. Skendros, P. Terzoudi, A. Georgiadis, G.S. Zebekakis, P. Maltezos, E. Piperidou, C. Heliopoulos, I. Vadikolias, K.

Abstract

Up to date there is no population-based study from Greece providing long-term data on incidence of both all-cause mortality and stroke recurrence for patients with first ever stroke (FES). Adult patients with FES were registered during a 24-month period (2010–2012) and followed-up for 12 months. We calculated cumulative incidences of stroke mortality and recurrence. Univariable and multivariable Cox proportional hazards regression analyses were used to identify independent determinants of 1-year mortality and 1-year stroke recurrence. We prospectively documented 703 first ever stroke cases (mean age 75 ± 12 years; 52.8% males; ischemic stroke 80.8%, intracerebral hemorrhage 11.8%, subarachnoid hemorrhage 4.4%, undefined 3.0%) with a total follow-up time of 119,805 person-years. The cumulative incidence rates of mortality of all FES patients at 28 days, 3 months and 1 year were 21.3% (95% CI 18.5–24.5%), 26% (95% CI 22.9–29.4%) and 34.7% (95% CI 31.3–38.3%), respectively. The risk of 1-year mortality was independently (p < 0.05) associated with advancing age, history of hypertension, increased stroke severity on admission, and hemorrhagic FES type. Cumulative 1-year stroke mortality differed according to both index FES type (ischemic vs. hemorrhage; p < 0.001), but also across different ischemic stroke subtypes (p = 0.025). The cumulative incidence rates of recurrent stroke at 28 days, 3 months and 1 year were 2.0% (95% CI 1.2–3.6%), 4.2% (2.8–6.2%) and 6.7% (5.1–8.8%), respectively. Comparable to other population-based surveys, our study reports 1-year mortality and stroke recurrence rates in patients with FES. These findings highlight the need for effective secondary prevention strategies in a border region of southeastern Europe, which exhibits very high FES incidence rates. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

Published
2018

30. Treatment options of complicated urinary tract infections in ectopic kidneys: A case report

Author

Triantafyllou, S. Aggelis, S. Tzavelas, D. Kontoteza, I.-V. Skandalakis, P. Filippou, D.

Abstract

Renal ectopia is a relatively rare situation which may complicate the diagnosis. In cases with renal ectopia, the normal route of the urinary tract alters and may be associated with increased incidence of infections or coexist with other malformations. We report a female patient with unobstructed pelvic renal ectopia complicated by urinary tract infection. After presenting our diagnostic and therapeutic dilemmas and strategy, we discuss the existing diagnostic and treating options including conservative and surgical approaches. © 2018 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.

Published
2018

31. Acid and nonacid gastroesophageal reflux after single anastomosis gastric bypass. An objective assessment using 24-hour multichannel intraluminal impedance-pH metry

Author

Doulami, G. Triantafyllou, S. Albanopoulos, K. Natoudi, M. Zografos, G. Theodorou, D.

Subjects
digestive system diseases
Abstract

Background: Single anastomosis gastric bypass (SaGB) was introduced in 2001 as an alternative to “loop” gastric bypass. It was considered as a procedure that would eliminate alkaline reflux and associated esophagitis. Objectives: Existing evidence about the postoperative incidence of gastroesophageal reflux (GERD) after SaGB is based on studies using symptom questionnaires. The aim of our study was to evaluate GERD 12 months after SaGB by using 24-hour multichannel intraluminal impedance pH metry (24-h MIIpH). Setting: Surgical department of a university hospital Methods: Morbidly obese candidates for SaGB underwent 24-hour MIIpH prior and 12 months after their bariatric procedure. Results: There were 11 patients included in this prospective study. Results of 24-hour MIIpH revealed that DeMeester score (40.48 versus 24.16, P =.339) had an increasing trend 12 months after SaGB. Acid reflux episodes decreased, whereas nonacid reflux episodes increased postoperatively, both in proximal and distal esophagus. Total median bolus clearance time and acid clearance time increased. De novo GERD developed in 2 patients (28.6%) and worsening of already existing GERD developed in all patients with preoperative evidence of GERD. Conclusion: The use of symptom questionnaires to assess postoperative GERD after SaGB may not accurately depict the real image. Twenty-four–hour MIIpH in 12 months after SaGB revealed an increase of total number of nonacid reflux episodes and a decrease of total number of acid reflux episodes, with longer duration of each acid reflux episode. Close postoperative follow-up with reflux testing and possibly endoscopy could eliminate the risk of complicated GERD. © 2017 American Society for Bariatric Surgery

Published
2018

32. Direct oral anticoagulant-vs Vitamin K antagonist-related nontraumatic intracerebral hemorrhage

Author

Tsivgoulis, G. Lioutas, V.-A. Varelas, P. Katsanos, A.H. Goyal, N. Mikulik, R. Barlinn, K. Krogias, C. Sharma, V.K. Vadikolias, K. Dardiotis, E. Karapanayiotides, T. Pappa, A. Zompola, C. Triantafyllou, S. Kargiotis, O. Ioakeimidis, M. Giannopoulos, S. Kerro, A. Tsantes, A. Mehta, C. Jones, M. Schroeder, C. Norton, C. Bonakis, A. Chang, J. Alexandrov, A.W. Mitsias, P. Alexandrov, A.V.

Subjects
cardiovascular diseases, nervous system diseases
Abstract

Objective: To compare the neuroimaging profile and clinical outcomes among patients with intracerebral hemorrhage (ICH) related to use of vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs) for nonvalvular atrial fibrillation (NVAF). Methods: We evaluated consecutive patients with NVAF with nontraumatic, anticoagulantrelated ICH admitted at 13 tertiary stroke care centers over a 12-month period. We also performed a systematic review and meta-analysis of eligible observational studies reporting baseline characteristics and outcomes among patients with VKA-or DOAC-related ICH. Results: We prospectively evaluated 161 patients with anticoagulation-related ICH (mean age 75.66 9.8 years, 57.8% men, median admission NIH Stroke Scale [NIHSSadm] score 13 points, interquartile range 6-21). DOAC-related (n 5 47) and VKA-related (n 5 114) ICH did not differ in demographics, vascular risk factors, HAS-BLED and CHA2DS2-VASc scores, and antiplatelet pretreatment except for a higher prevalence of chronic kidney disease in VKA-related ICH. Patients with DOAC-related ICH had lower median NIHSSadm scores (8 [3-14] vs 15 [7-25] points, p 5 0.003), median baseline hematoma volume (12.8 [4-40] vs 24.3 [11-58.8] cm3, p 5 0.007), and median ICH score (1 [0-2] vs 2 [1-3] points, p5 0.049). Severe ICH (.2 points) was less prevalent in DOAC-related ICH (17.0% vs 36.8%, p 5 0.013). In multivariable analyses, DOAC-related ICH was independently associated with lower baseline hematoma volume (p 5 0.006), lower NIHSSadm scores (p 5 0.022), and lower likelihood of severe ICH (odds ratio [OR] 0.34, 95% confidence interval [CI] 0.13-0.87, p 5 0.025). In meta-analysis of eligible studies, DOAC-related ICH was associated with lower baseline hematoma volumes on admission CT (standardized mean difference 5 20.57, 95% CI 21.02 to 20.12, p 5 0.010) and lower in-hospital mortality rates (OR 5 0.44, 95% CI 0.21-0.91, p 5 0.030). Conclusions: DOAC-related ICH is associatedwith smaller baseline hematoma volume and lesser neurologic deficit at hospital admission compared to VKA-related ICH. © 2017 American Academy of Neurology.

Published
2017

33. Duration of paroxysmal atrial fibrillation in cryptogenic stroke is not associated with stroke severity and early outcomes

Author

Liantinioti, C. Tympas, K. Katsanos, A.H. Parissis, J. Chondrogianni, M. Zompola, C. Papadimitropoulos, G. Ioakeimidis, M. Triantafyllou, S. Roussopoulou, A. Voumvourakis, K. Lekakis, J. Filippatos, G. Stefanis, L. Tsivgoulis, G.

Subjects
cardiovascular diseases
Abstract

The current definition of paroxysmal atrial fibrillation (PAF) requires an arbitrary cut-off of > 30s, but in clinical practice cryptogenic stroke (CS) patients with PAF duration of ≤ 30s are not usually excluded from anticoagulation therapy. We sought to evaluate the clinical relevance of short-duration (≤ 30s) PAF in CS. Consecutive CS patients with no prior AF history and sinus-rhythm on baseline electrocardiography (ECG) were prospectively evaluated over a three-year period. Baseline stroke severity was assessed by NIHSS-scores. All patients underwent 24-hour Holter-ECG during hospitalization. ECG recordings were analyzed by two blinded investigators using dedicated analysis software. Total time in AF was calculated as the sum of each individual AF episode for patients with multiple episodes during monitoring. Patients were dichotomized in two groups using PAF total duration (≤ 30s & > 30s). Early recurrent stroke and favorable functional outcome (FFO, defined as mRS-grades of 0–1) were evaluated during a three-month follow-up period. A total of 184 patients (66% men, mean age 57 ± 11 years) with CS (median NIHSS-score 4, IQR: 2–7) were evaluated. PAF of any duration was detected in 23 individuals (13%; 95%CI: 8%–18%). Among these patients the prevalence of brief PAF was 57% (n = 13). The two groups did not differ (p > 0.2) in terms of demographics, vascular risk factors and NIHSS-scores. Early recurrent stroke and FFO rates were similar (p > 0.4) in the two groups. Duration of PAF is not associated with baseline stroke severity and early outcomes in patients with CS and should not influence anticoagulation decision in these patients. © 2017

Published
2017

34. 'Normal Values of 24H Multichannel Intraluminal Impedance pH-Metry in a Greek Obese Population Based on Montreal Definition of Gerd'

Author

Doulami, G. Triantafyllou, S. Natoudi, M. Albanopoulos, K. Menenakos, E. Filis, K. Zografos, G. Theodorou, D.

Abstract

Background: Although several studies reporting normal values of 24h multichannel intraluminal impedance pH (MIIpH) have been published, none of them has ever studied obese individuals. The purpose of this study is to determine overall frequency and duration of reflux episodes (acid and non-acid, supine-upright, post and preprandial) in obese asymptomatic volunteers. Methods: Obese volunteers were enlisted during their preoperative evaluation for bariatric surgery. Volunteers had no gastroesophageal reflux disease (GERD) symptoms and no evidence of esophageal mucosal injury on endoscopy. Participants underwent a 24h MIIpH. Results: In this prospective observational study, data of 22 obese individuals were analyzed. Mean age was 41.9 years and mean BMI was 47.1 kg/m2. Mean total reflux episodes was 55.6 and 95th percentile was 99.7. Mean percentage of total time with pH

Published
2016

35. Cutaneous metastases from esophageal a denocarcinoma

Author

Triantafyllou, S. Georgia, D. Gavriella-Zoi, V. Dimitrios, M. Stulianos, K. Theodoros, L. Georgios, Z. Dimitrios, T.

Abstract

The aim of this study is to present 2 rare cases of cutaneous metastases originated from adenocarcinoma of the gastro-esophageal junction, thus, underline the need for early diagnosis and possible treatment of suspicious skin lesions among patients with esophageal malignancy. Metastatic cancer to the skin originated from internal malignancies, mostly lung cancer, breast cancer, and colorectal cancer, constitute 0.5 to 9% of all metastatic cancers.5,8,15 Skin metastases, mainly from squamous cell carcinomas of the esophagus, are rarely reported. Cutaneous metastasis is a finding indicating progressiveness of the disease.17 More precisely, median survival is estimated approximately 4.7 months.2,14 This study is a retrospective review of 2 cases of patients with adenocarcinoma of the esophagus and a review of the literature. Two patients aged 60 and 32 years old, respectively, underwent esophagectomy. Both pathologic reports disclosed adenocarcinoma of the gastro-esophageal junction staged T3 N2 M0 (stage IIIB). During follow-up time, the 2 patients were diagnosed with cutaneous metastases originated from the primary esophageal tumor 11 and 4 months after surgery, respectively. The first patient is alive 37 months after diagnosis, while the second one died 16 months after surgery. Cutaneous metastasis caused by esophageal adenocarcinoma is possible. Therefore, follow-up of patients who were diagnosed with esophageal malignancy and underwent esophagectomy is mandatory in order to reveal early surgical stages.

Published
2015

36. Phase-field material point method for brittle fracture.

Author

Kakouris, E. G. and Triantafyllou, S. P.

Subjects
FINITE element method, BRITTLE fractures, STRUCTURAL failures, CONTINUUM damage mechanics, NUMERICAL analysis
Abstract

The material point method for the analysis of deformable bodies is revisited and originally upgraded to simulate crack propagation in brittle media. In this setting, phase-field modelling is introduced to resolve the crack path geometry. Following a particle in cell approach, the coupled continuum/phase-field governing equations are defined at a set of material points and interpolated at the nodal points of an Eulerian, ie, non-evolving, mesh. The accuracy of the simulated crack path is thus decoupled from the quality of the underlying finite element mesh and relieved from corresponding mesh-distortion errors. A staggered incremental procedure is implemented for the solution of the discrete coupled governing equations of the phase-field brittle fracture problem. The proposed method is verified through a series of benchmark tests while comparisons are made between the proposed scheme, the corresponding finite element implementation, and experimental results. [ABSTRACT FROM AUTHOR]

Published
2017
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37. Logarithmic Spin, Logarithmic Rate and Material Frame-Indifferent Generalized Plasticity.

Author

Soldatos, D. and Triantafyllou, S. P.

Abstract

In this work, we present a new rate type formulation of large deformation generalized plasticity which is based on the consistent use of the logarithmic rate concept. For this purpose, the basic constitutive equations are initially established in a local rotationally neutralized configuration which is defined by the logarithmic spin. These are then rephrased in their spatial form, by employing some standard concepts from the tensor analysis on manifolds. Such an approach, besides being compatible with the notion of (hyper)elasticity, offers three basic advantages, namely: (i) The principle of material frame-indifference is trivially satisfied. (ii) The structure of the infinitesimal theory remains essentially unaltered. (iii) The formulation does not preclude anisotropic response. A general integration scheme for the computational implementation of generalized plasticity models which are based on the logarithmic rate is also discussed. The performance of the scheme is tested by two representative numerical examples. [ABSTRACT FROM AUTHOR]

Published
2016
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39. Bouc-Wen Type Hysteretic Plane Stress Element.

Author

Triantafyllou, S. P. and Koumousis, V. K.

Subjects
*STRAINS & stresses (Mechanics), *ELASTOPLASTICITY, *DYNAMICS, *DIMENSIONAL analysis, *NUMERICAL solutions to equations, *NONLINEAR systems, *STIFFNESS (Mechanics)
Abstract

In this work, a plane-stress element is proposed for the elastoplastic dynamic analysis of two-dimensional structures exhibiting hysteretic behavior. The constant-strain triangular element formulation for the elastic case is modified by introducing the Bouc-Wen hysteretic model, properly defined in the 2D stress-strain space. Solutions are obtained by simultaneously solving two sets of governing equations, namely the global equilibrium equations and the local constitutive equations, using a predictor-corrector differential equation solver. In following the proposed method, the linearization of the constitutive relations usually performed in step-by-step solution approaches is avoided. The proposed element is capable of modeling cyclic induced phenomena such as stiffness degradation and strength deterioration. Furthermore, the solution method implemented improves the accuracy of the results without increasing the computational cost of the analysis. Examples are presented which demonstrate the efficiency of the proposed approach. The method can be extended to other types of finite elements by properly incorporating the nonlinear constitutive behavior into their stiffness matrices. [ABSTRACT FROM AUTHOR]

Published
2012
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40. Small and Large Displacement Dynamic Analysis of Frame Structures Based on Hysteretic Beam Elements.

Author

Triantafyllou, S. and Koumousis, V.

Subjects
*NONLINEAR theories, *KINEMATICS, *ELASTOPLASTICITY, *FINITE element method, *MATHEMATICAL models of strains & stresses, *INTERPOLATION, *BOUC-Wen model
Abstract

In this work, a beam element is proposed for the nonlinear dynamic analysis of frame structures. The classical Euler-Bernoulli formulation for the elastic beam is extended by implicitly defining new hysteretic degrees of freedom, subjected to evolution equations of the Bouc-Wen type with kinematic hardening. A linear interpolation field is employed for these new degrees of freedom, which are regarded as hysteretic curvatures and hysteretic axial deformations. By means of the principle of virtual work, an elastoplastic hysteretic stiffness relation is derived, which together with the hysteretic evolution equations fully describes the behavior of the element. The elemental stiffness equations are assembled to form a system of linear global equations of motion that also depend on the introduced hysteretic variables. The solution is obtained by simultaneously solving the entire set of governing equations, namely the linear global equations of motion with constant coefficient matrices, and the nonlinear local constitutive equations for every element converted into a state-space form. Numerical results are presented to demonstrate the efficiency of the method as compared to existing methods. [ABSTRACT FROM AUTHOR]

Published
2012
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44. Heterogeneity in the Effect of Early Goal-Directed Therapy for Septic Shock: A Secondary Analysis of Two Multicenter International Trials.

Author

Shah FA, Talisa VB, Chang CH, Triantafyllou S, Tang L, Mayr FB, Higgins AM, Peake SL, Mouncey P, Harrison DA, DeMerle KM, Kennedy JN, Cooper GF, Bellomo R, Rowan K, Yealy DM, Seymour CW, Angus DC, and Yende SP

Subjects
Humans, Female, Male, Middle Aged, Aged, Resuscitation methods, Australia, Machine Learning, United States, Shock, Septic therapy, Shock, Septic mortality, Early Goal-Directed Therapy methods
Abstract

Objectives: The optimal approach for resuscitation in septic shock remains unclear despite multiple randomized controlled trials (RCTs). Our objective was to investigate whether previously uncharacterized variation across individuals in their response to resuscitation strategies may contribute to conflicting average treatment effects in prior RCTs., Design: We randomly split study sites from the Australian Resuscitation of Sepsis Evaluation (ARISE) and Protocolized Care for Early Septic Shock (ProCESS) trials into derivation and validation cohorts. We trained machine learning models to predict individual absolute risk differences (iARDs) in 90-day mortality in derivation cohorts and tested for heterogeneity of treatment effect (HTE) in validation cohorts and swapped these cohorts in sensitivity analyses. We fit the best-performing model in a combined dataset to explore roles of patient characteristics and individual components of early goal-directed therapy (EGDT) to determine treatment responses., Setting: Eighty-one sites in Australia, New Zealand, Hong Kong, Finland, Republic of Ireland, and the United States., Patients: Adult patients presenting to the emergency department with severe sepsis or septic shock., Interventions: EGDT vs. usual care., Measurements and Main Results: A local-linear random forest model performed best in predicting iARDs. In the validation cohort, HTE was confirmed, evidenced by an interaction between iARD prediction and treatment ( p < 0.001). When patients were grouped based on predicted iARDs, treatment response increased from the lowest to the highest quintiles (absolute risk difference [95% CI], -8% [-19% to 4%] and relative risk reduction, 1.34 [0.89-2.01] in quintile 1 suggesting harm from EGDT, and 12% [1-23%] and 0.64 [0.42-0.96] in quintile 5 suggesting benefit). Sensitivity analyses showed similar findings. Pre-intervention albumin contributed the most to HTE. Analyses of individual EGDT components were inconclusive., Conclusions: Treatment response to EGDT varied across patients in two multicenter RCTs with large benefits for some patients while others were harmed. Patient characteristics, including albumin, were most important in identifying HTE., Competing Interests: Drs. Shah’s, Talisa’s, Chang’s, Tang’s, Cooper’s, Angus’s, and Yende’s institutions received funding from the National Institutes of Health (NIH; GM141081). Dr. Shah’s institution received funding from the NIH (K23GM122069, R21HL168070). Dr. Shah, Dr. Talisa, Dr. Chang, Dr. Triantafyllou, Dr. Tang, Mr. Kennedy, Dr. Cooper, Dr. Yealy, Dr. Seymour, Dr. Angus, and Dr. Yende received support for article research from the NIH. Dr. Talisa disclosed the study was supported by the NIH (UL1TR001857; S10OD028483). Dr. Triantafyllou, Mr. Kennedy, Dr. Cooper, and Dr. Seymour’s institutions received funding from the NIH (R01HL164835). Dr. Mayr’s institution received funding from the NIH (K23GM132688); he disclosed government work; and he received personal fees from Baxter for serving on a racial disparities advisory board outside the submitted work. Dr. Higgins’ institution received funding from the National Health and Medical Research Council (NHMRC) (GNT2008447); she received support for article research from the NHMRC. Mr. Mouncey’s institution received funding from the National Institute for Health and Care Research Health Technology Assessment program; he received support for article research from the National Institute for Health and Care Research. Mr. Kennedy’s and Dr. Seymour’s institutions received funding from the NIH (R21GM144851). Mr. Kennedy’s, Dr. Cooper’s, and Dr. Seymour’s institution received funding from the National Institute for General Medical Sciences (R35GM119519). Dr. Yealy’s institution received funding from the NIH. Dr. Seymour received funding from Beckman Coulter and Octapharma. Dr. Angus received funding from AM-Pharma and Abionyx. The remaining authors have disclosed that they do not have any potential conflicts of interest., (Copyright © 2024 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.)

Published
2025
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45. Massive Gastric Juvenile Polyposis Associated With Intermittent Gastric Outlet Obstruction: A Case Report.

Author

Linardoutsos D, Mela E, Triantafyllou S, and Machairas A

Abstract

Juvenile polyposis syndrome is a condition distinguished by numerous hyperproliferative polyps that can affect the entire gastrointestinal tract, though they are uncommon in the stomach. We report a rare case of a 70-year-old woman with a three-year history of epigastric pain and severe bloating who was referred to our department for gastric outlet obstruction due to massive gastric juvenile polyps also causing gastroparesis. The patient was successfully treated with a total gastrectomy., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Linardoutsos et al.)

Published
2024
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46. Diagnostic yield of implantable loop recorders: results from the hellenic registry.

Author

Letsas KP, Saplaouras A, Mililis P, Kariki O, Bazoukis G, Archontakis S, Anagnostopoulos I, Triantafyllou S, Palaiodimou L, Chatziantoniou A, Lykoudis A, Mpatsouli A, Katsa G, Kadda O, Dragasis S, Cheilas V, Tsetika EG, Asvestas D, Korantzopoulos P, Poulos G, Maounis T, Kostopoulou A, Kossyvakis C, Xydonas S, Giannopoulos G, Papagiannis J, Tsoutsinos A, Sidiropoulos G, Vassilikos V, Fragakis N, Tzeis S, Deftereos S, Dilaveris P, Sideris S, Efremidis M, and Tsivgoulis G

Abstract

Objective: Implantable loop recorders (ILRs) are increasingly being used for long-term cardiac monitoring in different clinical settings. The aim of this study was to investigate the real-world performance of ILRs-including the time to diagnosis-in unselected patients with different ILR indications., Methods and Results: In this multicenter, observational study, 871 patients with an indication of pre-syncope/syncope (61.9%), unexplained palpitations (10.4%), and atrial fibrillation (AF) detection with a history of cryptogenic stroke (CS) (27.7%) underwent ILR implantation. The median follow-up was 28.8 ± 12.9 months. In the presyncope/syncope group, 167 (31%) received a diagnosis established by the device. Kaplan-Meier estimates indicated that 16.9% of patients had a diagnosis at 6 months, and the proportion increased to 22.5% at 1 year. Of 91 patients with palpitations, 20 (22%) received a diagnosis based on the device. The diagnosis was established in 12.2% of patients at 6 months, and the proportion increased to 13.3% at 1 year. Among 241 patients with CS, 47 (19.5%) were diagnosed with AF. The diagnostic yield of the device was 10.4% at 6 months and 12.4% at 1 year. In all cases, oral anticoagulation was initiated. Overall, ILR diagnosis altered the therapeutic strategy in 26.1% of the presyncope/syncope group, 2.2% of the palpitations group, and 3.7% of the CS group in addition to oral anticoagulation initiation., Conclusion: In this real-world patient population, ILR determines diagnosis and initiates new therapeutic management for nearly one-fourth of patients. ILR implantation is valuable in the evaluation of patients with unexplained presyncope/syncope, CS, and palpitations., Competing Interests: Conflicts of interest None., (Copyright © 2024 Hellenic Society of Cardiology. Published by Elsevier Inc. All rights reserved.)

Published
2024
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47. Performance of Different Risk Scores for the Detection of Atrial Fibrillation Among Patients With Cryptogenic Stroke.

Author

Palaiodimou L, Theodorou A, Triantafyllou S, Dilaveris P, Flevari P, Giannopoulos G, Kossyvakis C, Adreanides E, Tympas K, Nikolopoulos P, Zompola C, Bakola E, Chondrogianni M, Magiorkinis G, Deftereos S, Giannopoulos S, Tsioufis K, Filippatos G, and Tsivgoulis G

Subjects
Humans, Risk Assessment, Risk Factors, Atrial Fibrillation complications, Atrial Fibrillation diagnosis, Atrial Fibrillation epidemiology, Stroke diagnosis, Stroke epidemiology, Stroke etiology, Ischemic Stroke complications
Abstract

Background: Atrial fibrillation (AF) is a frequent underlying cause of cryptogenic stroke (CS) and its detection can be increased using implantable cardiac monitoring (ICM). We sought to evaluate different risk scores and assess their diagnostic ability in identifying patients with CS with underlying AF on ICM., Methods: Patients with CS, being admitted to a single tertiary stroke center between 2017 and 2022 and receiving ICM, were prospectively evaluated. The CHA 2 DS 2 -VASc, HAVOC, Brown ESUS-AF, and C 2 HEST scores were calculated at baseline. The primary outcome of interest was the detection of AF, which was defined as at least 1 AF episode on ICM lasting for 2 consecutive minutes or more. The diagnostic accuracy measures and the net reclassification improvement were calculated for the 4 risk scores. Stroke recurrence was evaluated as a secondary outcome., Results: A total of 250 patients with CS were included, and AF was detected by ICM in 20.4% (n=51) during a median monitoring period of 16 months. Patients with CS with AF detection were older compared with the rest ( P =0.045). The median HAVOC, Brown ESUS-AF, and C 2 HEST scores were higher among the patients with AF compared with the patients without AF (all P <0.05), while the median CHA 2 DS 2 -VASc score was similar between the 2 groups. The corresponding C statistics for CHA 2 DS 2 -VASc, HAVOC, Brown ESUS-AF, and C 2 HEST for AF prediction were 0.576 (95% CI, 0.482-0.670), 0.612 (95% CI, 0.523-0.700), 0.666 (95% CI, 0.587-0.746), and 0.770 (95% CI, 0.699-0.839). The C 2 HEST score presented the highest diagnostic performance based on C statistics ( P <0.05 after correction for multiple comparisons) and provided significant improvement in net reclassification for AF detection (>70%) compared with the other risk scores. Finally, stroke recurrence was documented in 5.6% of the study population, with no difference regarding the 4 risk scores between patients with and without recurrent stroke., Conclusions: The C 2 HEST score was superior to the CHA 2 DS 2 -VASc, HAVOC, and Brown ESUS-AF scores for discriminating patients with CS with underlying AF using ICM., Competing Interests: Disclosures Dr Tsioufis reports the following interests that are unrelated to the present work: research grants from Medtronic, Recor, and Recordati and honoraria from Amgen, AstraZeneca, Boehringer Ingelheim, Bayer, Chiesi, Medtronic, Menarini, Novartis, Pfizer, Pharmanel, Sanofi, Servier, and Viatris. Dr Filippatos reports the following interests that are unrelated to the present work: Amgen (other), Bayer (other), Boehringer Ingelheim (other), European Commission (grant/contract), Impulse Dynamics, Inc (other), Medtronic (other), Novartis (other), Servier (other), and Vifor Pharma (End Point Review Committee). The other authors report no conflicts.

Published
2024
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48. Prolonged cardiac monitoring for stroke prevention: A systematic review and meta-analysis of randomized-controlled clinical trials.

Author

Tsivgoulis G, Palaiodimou L, Triantafyllou S, Köhrmann M, Dilaveris P, Tsioufis K, Magiorkinis G, Krogias C, Schellinger PD, Caso V, Paciaroni M, Sharma M, Lemmens R, Gladstone DJ, Sanna T, Wachter R, Filippatos G, and Katsanos AH

Subjects
Humans, Anticoagulants therapeutic use, Hemorrhage complications, Stroke diagnosis, Ischemic Attack, Transient complications, Atrial Fibrillation complications, Ischemic Stroke complications
Abstract

Introduction: Prolonged cardiac monitoring (PCM) substantially improves the detection of subclinical atrial fibrillation (AF) among patients with history of ischemic stroke (IS), leading to prompt initiation of anticoagulants. However, whether PCM may lead to IS prevention remains equivocal., Patients and Methods: In this systematic review and meta-analysis, randomized-controlled clinical trials (RCTs) reporting IS rates among patients with known cardiovascular risk factors, including but not limited to history of IS, who received PCM for more than 7 days versus more conservative cardiac rhythm monitoring methods were pooled., Results: Seven RCTs were included comprising a total of 9048 patients with at least one known cardiovascular risk factor that underwent cardiac rhythm monitoring. PCM was associated with reduction of IS occurrence compared to conventional monitoring (Risk Ratio: 0.76; 95% CI: 0.59-0.96; I 2  = 0%). This association was also significant in the subgroup of RCTs investigating implantable cardiac monitoring (Risk Ratio: 0.75; 95% CI: 0.58-0.97; I 2  = 0%). However, when RCTs assessing PCM in both primary and secondary prevention settings were excluded or when RCTs investigating PCM with a duration of 7 days or less were included, the association between PCM and reduction of IS did not retain its statistical significance. Regarding the secondary outcomes, PCM was related to higher likelihood for AF detection and anticoagulant initiation. No association was documented between PCM and IS/transient ischemic attack occurrence, all-cause mortality, intracranial hemorrhage, or major bleeding., Conclusion: PCM may represent an effective stroke prevention strategy in selected patients. Additional RCTs are warranted to validate the robustness of the reported associations., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© European Stroke Organisation 2022.)

Published
2023
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49. Delayed Leucoencephalopathy as a Complication after Endovascular Therapy of Intracranial Aneurysms-A Case Series.

Author

Bakola E, Papagiannopoulou G, Palaiodimou L, Lagios K, Archontakis E, Theodorou A, Katsanos AH, Triantafyllou S, Zouvelou V, Lachanis S, Tzanetakos D, Tzartos JS, Giannopoulos S, and Tsivgoulis G

Abstract

We describe the clinical presentation, radiological findings, treatment and outcomes of three patients with delayed leukoencephalopathy occurring after endovascular treatment (EVT) for cerebral aneurysms-a rare, albeit recurring, complication. The symptoms occurred 6 to 12 months following the EVT of the cerebral aneurysm. Characteristic imaging findings included high-signal changes on T2 images in the white matter without diffusion restriction predominantly at the distribution of the vascular territory of the catheterized arteries, coupled with patchy gadolinium enhancement or low susceptibility weighted imaging (SWI) signals within the white-matter lesions. Steroid pulse therapy is the treatment of choice and promptly improves clinical and imaging findings. Tapering or cessation of steroids may result in clinical and imaging relapses; close- and long-term follow-up for patients presenting this complication is warranted.

Published
2023
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50. Augmentation by Counterfactual Explanation - Fixing an Overconfident Classifier.

Author

Singla S, Murali N, Arabshahi F, Triantafyllou S, and Batmanghelich K

Abstract

A highly accurate but overconfident model is ill-suited for deployment in critical applications such as healthcare and autonomous driving. The classification outcome should reflect a high uncertainty on ambiguous in-distribution samples that lie close to the decision boundary. The model should also refrain from making overconfident decisions on samples that lie far outside its training distribution, far-out-of-distribution (far-OOD), or on unseen samples from novel classes that lie near its training distribution (near-OOD). This paper proposes an application of counterfactual explanations in fixing an over-confident classifier. Specifically, we propose to fine-tune a given pre-trained classifier using augmentations from a counterfactual explainer (ACE) to fix its uncertainty characteristics while retaining its predictive performance. We perform extensive experiments with detecting far-OOD, near-OOD, and ambiguous samples. Our empirical results show that the revised model have improved uncertainty measures, and its performance is competitive to the state-of-the-art methods.

Published
2023
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