256 results on '"Saarnio, J"'
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2. Predictors of anastomotic leak and conduit necrosis after oesophagectomy: Results from the oesophago-gastric anastomosis audit (OGAA)
- Author
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Halle-Smith, J.M., Kamarajah, S.K., Evans, R.P.T., Nepogodiev, D., Hodson, J., Bundred, J.R., Gockel, I., Gossage, J.A., Isik, A., Kauppila, J.H., 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., Bekele, A., Harustiak, T., Kechagias, A., Bagajevas, A., Kennedy, A., Da Roit, 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., 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., 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., Yr, Tan, S, Thannimalai, Ca, Ho, Ws, Pang, Jh, Tan, Hnl, Basave, 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., 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., 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., Mitchell, J.D., and Griffiths, Ewen A.
- Published
- 2024
- Full Text
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3. The influence of anastomotic techniques on postoperative anastomotic complications: Results of the Oesophago-Gastric Anastomosis Audit
- Author
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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
- Full Text
- View/download PDF
4. 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
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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.
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- 2023
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5. Changes in nutritional status and associated factors in a geriatric post-hip fracture assessment
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Helminen, H., Luukkaala, T., Saarnio, J., and Nuotio, M.S.
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- 2017
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6. Laparoscopic versus hybrid approach for treatment of incisional ventral hernia: a 5–10-year follow-up of the randomized controlled multicenter study
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Hiekkaranta, J. M., primary, Ahonen, M., additional, Mäkäräinen, E., additional, Saarnio, J., additional, Pinta, T., additional, Vironen, J., additional, Niemeläinen, S., additional, Vento, P., additional, Nikki, M., additional, Ohtonen, P., additional, and Rautio, T., additional
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- 2023
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7. Immunological and prognostic significance of tumour necrosis in colorectal cancer
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Kastinen, M. (Meeri), Sirniö, P. (Päivi), Elomaa, H. (Hanna), Ahtiainen, M. (Maarit), Väyrynen, S. A. (Sara A.), Herzig, K.-H. (Karl-Heinz), Meriläinen, S. (Sanna), Aro, R. (Raila), Häivälä, R. (Reetta), Rautio, T. (Tero), Saarnio, J. (Juha), Wirta, E.-V. (Erkki-Ville), Helminen, O. (Olli), Seppälä, T. T. (Toni T.), Kuopio, T. (Teijo), Böhm, J. (Jan), Tuomisto, A. (Anne), Mecklin, J.-P. (Jukka-Pekka), Mäkinen, M. J. (Markus J.), Väyrynen, J. P. (Juha P.), Kastinen, M. (Meeri), Sirniö, P. (Päivi), Elomaa, H. (Hanna), Ahtiainen, M. (Maarit), Väyrynen, S. A. (Sara A.), Herzig, K.-H. (Karl-Heinz), Meriläinen, S. (Sanna), Aro, R. (Raila), Häivälä, R. (Reetta), Rautio, T. (Tero), Saarnio, J. (Juha), Wirta, E.-V. (Erkki-Ville), Helminen, O. (Olli), Seppälä, T. T. (Toni T.), Kuopio, T. (Teijo), Böhm, J. (Jan), Tuomisto, A. (Anne), Mecklin, J.-P. (Jukka-Pekka), Mäkinen, M. J. (Markus J.), and Väyrynen, J. P. (Juha P.)
- Abstract
Background: Colorectal cancer (CRC) causes the second most cancer deaths worldwide, but the disease course varies according to tumour characteristics and immunological factors. Our objective was to examine the associations of tumour necrosis with tumour characteristics, immune cell infiltrates, serum cytokine concentrations, as well as prognosis in CRC. Methods: Three independent CRC cohorts, including 1413 patients, were analysed. Associations of the areal percentage of tumour necrosis with clinicopathologic parameters, tumour infiltrating immune cells, cytokine concentrations in systemic and mesenteric vein blood, and survival were examined. Results: Higher tumour necrosis percentage associated with shorter colorectal cancer-specific survival independent of tumour grade, T, N or M-class, mismatch repair status, BRAF status, and other possible confounding factors. In the largest cohort (N = 1100), the HR for high tumour necrosis percentage (≥40% vs. <3%) was 3.22 (95% CI 1.68–6.17, Ptrend < 0.0001). Tumour necrosis percentage positively correlated with peripheral serum levels of CXCL8, a proinflammatory chemokine, and negatively correlated with mesenteric serum levels of CXCL10 and mast cell densities in the invasive margin of the tumour. Conclusions: Our results support the value of tumour necrosis as a prognostic factor in colorectal cancer. CXCL8 may have a role in the systemic effects of tumour necrosis.
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- 2023
8. Preoperative esophageal stenting and 5-year survival in patients undergoing esophagectomy for esophageal cancer:a population-based nationwide study from Finland
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Helminen, O. (Olli), Sihvo, E. (Eero), Helmiö, M. (Mika), Huhta, H. (Heikki), Kallio, R. (Raija), Koivukangas, V. (Vesa), Kokkola, A. (Arto), Laine, S. (Simo), Lietzen, E. (Elina), Meriläinen, S. (Sanna), Pohjanen, V.-M. (Vesa-Matti), Rantanen, T. (Tuomo), Ristimäki, A. (Ari), Räsänen, J. V. (Jari V.), Saarnio, J. (Juha), Toikkanen, V. (Vesa), Tyrväinen, T. (Tuula), Valtola, A. (Antti), Kauppila, J. H. (Joonas H.), Helminen, O. (Olli), Sihvo, E. (Eero), Helmiö, M. (Mika), Huhta, H. (Heikki), Kallio, R. (Raija), Koivukangas, V. (Vesa), Kokkola, A. (Arto), Laine, S. (Simo), Lietzen, E. (Elina), Meriläinen, S. (Sanna), Pohjanen, V.-M. (Vesa-Matti), Rantanen, T. (Tuomo), Ristimäki, A. (Ari), Räsänen, J. V. (Jari V.), Saarnio, J. (Juha), Toikkanen, V. (Vesa), Tyrväinen, T. (Tuula), Valtola, A. (Antti), and Kauppila, J. H. (Joonas H.)
- Abstract
Background: Preoperative esophageal stenting is proposed to have a negative effect on outcomes. The aim was to compare a 5-year survival in patients undergoing esophagectomy for esophageal cancer with and without preoperative esophageal stent in a population-based nationwide cohort from Finland. The secondary outcome was 90-day mortality. Methods: This study included curatively intended esophagectomies for esophageal cancer in Finland between 1999 and 2016, with follow-up until December 31, 2019. Cox proportional hazards models provided hazard ratios (HRs) with 95% confidence intervals (CIs) of overall 5-year and 90-day mortality. Model 1 was adjusted for age, sex, year of the surgery, comorbidities, histology, pathological stage, and neoadjuvant therapy. Model 2 included also albumin level and BMI. Result: Of 1064 patients, a total of 134 patients underwent preoperative stenting and 930 did not. In both adjusted models 1 and 2, higher 5-year mortality was seen in patients with preoperative stent with HRs of 1.29 (95% CI 1.00–1.65) and 1.25 (95% CI 0.97–1.62), respectively, compared to no stenting. The adjusted HR of 90-day mortality was 2.49 (95% CI 1.27–4.87) in model 1 and 2.49 (95% CI 1.25–4.99) in model 2. When including only neoadjuvant-treated patients, those with preoperative stent had a 5-year survival of 39.2% compared to 46.4% without stent (adjusted HR 1.34, 95% CI 1.00–1.80), and a 90-day mortality rate of 8.5% and 2.5% (adjusted HR 3.99, 95% CI 1.51–10.50). Discussion: This nationwide study reports worse 5-year and 90-day outcomes in patients with preoperative esophageal stent. Since residual confounding remains possible, observed difference could be only an association rather than the cause.
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- 2023
9. Ruokatorven korroosiovammat:tunnista vaikeat
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Helminen, O. (Olli), Pennanen, A. (Aino), Saarnio, J. (Juha), Helminen, O. (Olli), Pennanen, A. (Aino), and Saarnio, J. (Juha)
- Abstract
Tiivistelmä Myrkytystietokeskukseen tulee vuosittain noin 30 puhelua, joissa syövyttävää happoa tai emästä on otettu suun kautta, ja noin 200 puhelua, joissa tiedetään tai epäillään, että henkilö on niellyt pariston. Oireettomissa ja lievissä happo- ja emäsaltistuksissa päivystyskäynti ei usein ole tarpeellinen tai potilas voidaan kotiuttaa lyhyen seurannan jälkeen. Merkittävissä altistuksissa päivystyksellinen tietokonekuvantaminen on tarkin keino vamman laajuuden arvioinnissa. Pinnalliset nekroosit aiheuttavat parantuessaan ruokatorven ahtaumia. Jos ruokatorvi puhkeaa korroosiovamman seurauksena, joudutaan päivystykselliseen leikkaushoitoon. Merkittäviin ruokatorven korroosiovammoihin liittyy kohonnut syöpäriski, joskin latenssiaika on yli 20 vuotta. Vaikeiden korroosiovammojen akuuttivaiheen ja myöhäiskomplikaatioiden hoito kuuluu ruokatorvikirurgian keskuksiin.
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- 2023
10. Impact of cholangitis on survival of patients with malignant biliary obstruction treated with percutaneous transhepatic biliary drainage
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Niemelä, J. (Jarmo), Kallio, R. (Raija), Ohtonen, P. (Pasi), Saarnio, J. (Juha), Syrjälä, H. (Hannu), Niemelä, J. (Jarmo), Kallio, R. (Raija), Ohtonen, P. (Pasi), Saarnio, J. (Juha), and Syrjälä, H. (Hannu)
- Abstract
Purpose: To evaluate the impact of cholangitis on survival of patients with gastrointestinal cancer and malignant biliary obstruction treated with percutaneous transhepatic biliary drainage (PTBD). Methods: A retrospective registry study was performed at a tertiary center from 2000 to 2016 in Northern Finland. Results: The study included 588 patients, 258 (43.9%) patients with pancreatic cancer, 222 (37.7%) with biliary tract cancer, and 108 (18.4%) with metastasis from gastrointestinal cancers. Patient mean age was 70 years, range 26 − 93 years. There were 288 [49.0%] women. The 30-day mortality rate was 30.8% for 156 patients with cholangitis before PTBD, 19.5% for 215 patients with cholangitis after PTBD and 25.8% for 217 patients without cholangitis (P = 0.039). The median survival was 1.8 months for patients with cholangitis before PTBD, 3.0 months for patients with cholangitis after PTBD, and 3.2 months for patients without cholangitis (P = 0.002). The hazard ratio (HR) for 1-year mortality for patients with cholangitis before PTBD was 1.3 (95% CI 1.06 − 1.67, P = 0.015) compared to patients with cholangitis after PTBD. After successful PTBD, 54 out of 291 patients received chemotherapy; the median survival was 5.2 months with cholangitis before PTBD, 9.4 months with cholangitis after PTBD and 15.3 months without cholangitis. Conclusion: In gastrointestinal cancers with malignant biliary obstruction, survival is poorer if cholangitis occurs before PTBD compared to cholangitis after PTBD. An oncologist’s consultation is essential for assessing the possibility of chemotherapy in successfully treated PTBD patients, because of the notable survival benefit.
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- 2023
11. 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)
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MS CGO, Cancer, Steering Committee, Committee, Alderson, D., Bundred, J., Rpt, Evans, Gossage, J., Griffiths, E. A., Jefferies, B., Kamarajah, S. K., McKay, S., Mohamed, Nepogodiev, D., Siaw- Acheampong, K., Singh, P., Van Hillegersberg, R., Vohra, R., Wanigasooriya, K., Whitehouse, T., National Leads, Leads, Gjata, A., Moreno, J. I., Takeda, F. R., Kidane, B., Guevara Castro, R., Harustiak, T., Bekele, A., Kechagias, A., Gockel, Kennedy, A., Da Roit, A., Bagajevas, A., Azagra, J. S., Mahendran, H. A., Mejía-Fernández, L., Wijnhoven, B. P.L., El Kafsi, J., Sayyed, R. H., Sousa, M., Sampaio, A. S., Negoi, Blanco, R., Wallner, B., Schneider, P. M., Hsu, P. K., Isik, A., Leads, Site, Gananadha, S., Wills, 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, 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., Okonta, K. E., 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, Hedberg, J., Mönig, S., Gutknecht, S., Tez, M., Guner, A., Tirnaksiz, M. B., Colak, E., Sevinç, B., Hindmarsh, A., Khan, 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., Collaborators, 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, Raa, Sallum, Da Rocha, J. R.M., Lopes, L. R., Tercioti, V., Jds, Coelho, 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., Kruhlikava, Morten B., 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, 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., Hnl, Basave, 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., Sba, Qudus, Sarwar, M. Z., Shehzadi, A., Raza, A., Jhanzaib, M. H., Farmanali, J., Zakir, Z., Shakeel, O., Nasir, 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., Negoita, Ciubotaru C., Cordos, Birla, R. D., Predescu, D., Hoara, P. A., Tomsa, R., Shneider, Agasiev, M., Ganjara, Gunjić, D., Veselinović, M., Babič, T., Chin, T. S., Shabbir, A., Kim, G., Crnjac, A., Samo, H., Díez Del Val, Del Val, 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., Epg, Santos, Martínez, E. T., Fernández Díaz, M. J., Magadán Álvarez, C., Martín, Concepción, 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, 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, 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., Wilson, M. Lorenzi B., Patil, P., Noaman, 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., Mitchell, J. D., MS CGO, Cancer, Steering Committee, Committee, Alderson, D., Bundred, J., Rpt, Evans, Gossage, J., Griffiths, E. A., Jefferies, B., Kamarajah, S. K., McKay, S., Mohamed, Nepogodiev, D., Siaw- Acheampong, K., Singh, P., Van Hillegersberg, R., Vohra, R., Wanigasooriya, K., Whitehouse, T., National Leads, Leads, Gjata, A., Moreno, J. I., Takeda, F. R., Kidane, B., Guevara Castro, R., Harustiak, T., Bekele, A., Kechagias, A., Gockel, Kennedy, A., Da Roit, A., Bagajevas, A., Azagra, J. S., Mahendran, H. A., Mejía-Fernández, L., Wijnhoven, B. P.L., El Kafsi, J., Sayyed, R. H., Sousa, M., Sampaio, A. S., Negoi, Blanco, R., Wallner, B., Schneider, P. M., Hsu, P. K., Isik, A., Leads, Site, Gananadha, S., Wills, 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, 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., Okonta, K. E., 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, Hedberg, J., Mönig, S., Gutknecht, S., Tez, M., Guner, A., Tirnaksiz, M. B., Colak, E., Sevinç, B., Hindmarsh, A., Khan, 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., Collaborators, 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, Raa, Sallum, Da Rocha, J. R.M., Lopes, L. R., Tercioti, V., Jds, Coelho, 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., Kruhlikava, Morten B., 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, 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., Hnl, Basave, 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., Sba, Qudus, Sarwar, M. Z., Shehzadi, A., Raza, A., Jhanzaib, M. H., Farmanali, J., Zakir, Z., Shakeel, O., Nasir, 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., Negoita, Ciubotaru C., Cordos, Birla, R. D., Predescu, D., Hoara, P. A., Tomsa, R., Shneider, Agasiev, M., Ganjara, Gunjić, D., Veselinović, M., Babič, T., Chin, T. S., Shabbir, A., Kim, G., Crnjac, A., Samo, H., Díez Del Val, Del Val, 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., Epg, Santos, Martínez, E. T., Fernández Díaz, M. J., Magadán Álvarez, C., Martín, Concepción, 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, 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, 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., Wilson, M. Lorenzi B., Patil, P., Noaman, 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
- 2023
12. Mortality from esophagectomy for esophageal cancer across low, middle, and high-income countries: An international cohort study
- Author
-
Kamarajah, Sk, Nepogodiev, D, Bekele, A, Cecconello, I, Evans, Rpt, Guner, A, Gossage, Ja, Harustiak, T, Hodson, J, Isik, A, Kidane, B, Leon-Takahashi, Am, Mahendran, Ha, Negoi, I, Okonta, Ke, Rosero, G, Sayyed, Rh, Singh, P, Takeda, Fr, van Hillegersberg, R, Vohra, Rs, White, Re, Griffiths, Ea, Alderson, D, Bundred, J, Gossage, J, Jefferies, B, Mckay, S, Mohamed, I, Siaw-Acheampong, K, Vohra, R, Wanigasooriya, K, Whitehouse, T, Gjata, A, Moreno, Ji, Guevara, Cr, Kechagias, A, Gockel, I, Kennedy, A, Da Roit, A, Bagajevas, A, Azagra, Js, Mejia-Fernandez, L, Wijnhoven, Bpl, El Kafsi, J, Sousa, M, Sampaio, As, Blanco, R, Wallner, B, Schneider, Pm, Hsu, Pk, Gananadha, S, Wills, V, Devadas, M, Duong, C, Talbot, M, Hii, Mw, Jacobs, R, Andreollo, Na, Johnston, B, Darling, G, Isaza-Restrepo, A, 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, 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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 L.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 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 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
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Male ,Esophageal Neoplasms ,SURGERY ,IMPACT ,medicine.medical_treatment ,Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] ,0302 clinical medicine ,FAILURE ,Postoperative Period ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,Generalized estimating equation ,COMPLICATIONS ,ddc:617 ,Anastomosis, Surgical ,General Medicine ,Middle Aged ,Esophageal cancer ,Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10] ,HOSPITAL VOLUME ,Oncology ,Esophagectomy ,030220 oncology & carcinogenesis ,Anastomotic leak ,Global surgery ,Postoperative mortality ,Female ,Cohort study ,Adult ,medicine.medical_specialty ,Necrosis ,03 medical and health sciences ,All institutes and research themes of the Radboud University Medical Center ,Esophagus ,SDG 3 - Good Health and Well-being ,Internal medicine ,medicine ,Humans ,Developing Countries ,Aged ,business.industry ,Developed Countries ,Cancer ,Odds ratio ,GLOBAL BURDEN ,RESCUE ,medicine.disease ,Confidence interval ,Surgery ,business - 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.
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- 2021
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13. Postoperative outcomes in oesophagectomy with trainee involvement
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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.
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- 2022
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14. BJS-04 OUTCOMES OF OPEN VERSUS ROBOTIC-ASSISTED LAPAROSCOPIC POSTERIOR COMPONENT SEPARATION IN COMPLEX ABDOMINAL WALL REPAIR. A RETROSPECTIVE MULTICENTER CASE-CONTROL STUDY
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Dewulf, M, primary, Hiekkaranta, J, additional, Mäkaräinen, E, additional, Saarnio, J, additional, Vierstraete, M, additional, Ohtonen, P, additional, Muysoms, F, additional, and Rautio, T, additional
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- 2022
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15. Perioperative oral nutritional support for patients diagnosed with primary colon adenocarcinoma undergoing radical surgical procedures -Peri-Nutri Trial:study protocol for a randomized controlled trial
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Aro, R. (Raila), Ohtonen, P. (Pasi), Rautio, T. (Tero), Saarnio, J. (Juha), Mäkäräinen, E. (Elisa), Häivälä, R. (Reetta), Mäkinen, M. J. (Markus J.), Tuomisto, A. (Anne), Schwab, U. (Ursula), Meriläinen, S. (Sanna), Aro, R. (Raila), Ohtonen, P. (Pasi), Rautio, T. (Tero), Saarnio, J. (Juha), Mäkäräinen, E. (Elisa), Häivälä, R. (Reetta), Mäkinen, M. J. (Markus J.), Tuomisto, A. (Anne), Schwab, U. (Ursula), and Meriläinen, S. (Sanna)
- Abstract
Background: Colon cancer is one of the most common cancers in Finland and worldwide. Cancer-related malnutrition is a well-known risk factor for increased morbidity and mortality after surgery, and it is associated with complications and longer hospitalizations. There are no established recommendations on how to improve the nutritional status of colon cancer patients’ during the perioperative phase. Administration of simple oral nutritional supplements has been suggested to reduce complication rates, but evidence to support this practice is scarce. Methods: The Peri-Nutri trial is a prospective, multicenter, randomized, controlled trial. Its primary endpoint is to evaluate whether perioperative oral nutritional support (ONS) decreases the number of complications during the 30-day follow-up after surgery. Secondary endpoints are to study the effect of ONS on quality of life after surgery, length of stay in institutional care, 90-day mortality rate, five-year disease-free survival and overall survival. The patients with a Nutritional risk screening 2002 (NRS-2002) questionnaire result between 2 and 5 (≥ 3 are classified at risk of malnutrition) will be randomized (1:1 ratio) into either the intervention or control group. The intervention group will receive preoperative ONS two weeks before the operation, and nutritional support will continue 10 days after the operation. The control group will not receive ONS. A total of 318 patients will be randomized into two groups and patients are followed five years. Discussion: Peri-Nutri study evaluate the impact of ONS to short-term and long-term postoperative morbidity and mortality rates of colon cancer patients undergoing curative surgery. If ONS will decrease patients’ morbidity and mortality, that has a huge impact on patients’ quality of life and also to financial cost.
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- 2022
16. Ruokatorvi- ja mahasyövän riskiin voidaan vaikuttaa
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Arkkila, P. (Perttu), Saarnio, J. (Juha), Arkkila, P. (Perttu), and Saarnio, J. (Juha)
- Abstract
Tiivistelmä Ruokatorvisyöpä on lisääntynyt Suomessa jo kahdenkymmenen vuoden ajan. Mahasyövän ilmaantuvuus pienenee. Näille syöville altistavat tupakanpoltto, ruoka-aineet ja etenkin mahasyövälle infektiot. Perinnöllisillä tekijöillä on myös merkitystä. Runsaasti tuoreita vihanneksia ja hedelmiä sisältävä ruokavalio todennäköisesti vähentää ruokatorven ja mahalaukun syöpien riskiä. Laadukas endoskopia on edellytys syöpien esiasteiden diagnostiikalle ja hoidolle.
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- 2022
17. Predictive value of p53, Ki67 and TLR5 in neoplastic progression of Barrett’s esophagus:a matched case–control study
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Helminen, O. (Olli), Melkko, J. (Jukka), Saarnio, J. (Juha), Sihvo, E. (Eero), Kuopio, T. (Teijo), Ohtonen, P. (Pasi), Kauppila, J. H. (Joonas H.), Karttunen, T. J. (Tuomo J.), Huhta, H. (Heikki), Helminen, O. (Olli), Melkko, J. (Jukka), Saarnio, J. (Juha), Sihvo, E. (Eero), Kuopio, T. (Teijo), Ohtonen, P. (Pasi), Kauppila, J. H. (Joonas H.), Karttunen, T. J. (Tuomo J.), and Huhta, H. (Heikki)
- Abstract
Barrett’s esophagus progresses to high-grade dysplasia or cancer along the well-established metaplasia-dysplasia-adenocarcinoma sequence. The aim of this study was to evaluate the value of p53, Ki67, and toll-like receptor 5 (TLR5) in prediction of malignant progression of Barrett’s metaplasia and low-grade dysplasia. This was a retrospective matched case–control study based on Northern and Central Finland population. Patients diagnosed with esophageal high-grade dysplasia or adenocarcinoma were included. From these patients, all previous endoscopy samples were obtained along with original diagnostic HE-slides and clinical data. Age- and sex-matched patients with non-progressing Barrett’s metaplasia and low-grade dysplasia confirmed with follow-up endoscopies were used as controls. Two gastrointestinal pathologist re-reviewed all original HE-slides, and newly made sections to confirm representative tissue material blinded from clinical data. p53, Ki67, and TLR5 were immunohistochemically stained. Final cohort included 45 patients with progressive Barrett’s metaplasia (n = 21) or low-grade dysplasia (n = 24), and 92 patients with non-progressive Barrett’s metaplasia (n = 52) or low-grade dysplasia (n = 40). In Barrett’s metaplasia, aberrant p53 expression was observed in 6% of samples in progressors and 0% in non-progressors. In low-grade dysplasia, aberrant p53 was seen in 56% of samples in progressors and 17% in non-progressors (Odd’s ratio 6.7, 95% CI 1.8–24.6). Ki67 or TLR5 showed no association with disease progression. In this matched case–control study, p53 expression associated with a high risk of malignant progression in Barrett’s low-grade dysplasia. Routine staining of p53 is indicated in expert confirmed low-grade dysplasia.
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- 2022
18. Open versus robotic-assisted laparoscopic posterior component separation in complex abdominal wall repair
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Dewulf, M. (Maxime), Hiekkaranta, J. M. (Juha M.), Mäkäräinen, E. (Elisa), Saarnio, J. (Juha), Vierstraete, M. (Maaike), Ohtonen, P. (Pasi), Muysoms, F. (Filip), Rautio, T. (Tero), Dewulf, M. (Maxime), Hiekkaranta, J. M. (Juha M.), Mäkäräinen, E. (Elisa), Saarnio, J. (Juha), Vierstraete, M. (Maaike), Ohtonen, P. (Pasi), Muysoms, F. (Filip), and Rautio, T. (Tero)
- Abstract
Background: Transversus abdominis release (TAR) is a surgical technique used in the treatment of complex ventral hernias. The aim of this study was to compare outcomes of open (oTAR) versus robotic-assisted (rTAR) posterior component separation by TAR. Methods: Consecutive patients at two European hernia centres who underwent bilateral TAR were included. The primary endpoint was the duration of postoperative hospital stay. Results: Data from 90 rTAR and 79 oTAR operations were evaluated. Patient demographics were similar between groups in terms of age, sex, BMI, and co-morbidities. There were more smokers, and hernias were larger in the oTAR group (width 8.7 cm versus 10.0 cm; P = 0.031, length 11.6 cm versus 14.1 cm; P = 0.005). Duration of postoperative hospital stay was significantly shorter in the rTAR group (3.4 days versus 6.9 days; P < 0.001). Short-term serious complications (Clavien–Dindo grade III and above) were more frequent (20.3 per cent versus 7.8 per cent; P = 0.018), and there were more surgical site infections (12.7 per cent versus 3.3 per cent; P = 0.010) in the oTAR group. During a median follow-up of 19 months in the rTAR group and 43 months in the oTAR group, reoperation (4.4 per cent versus 8.9 per cent; P = 0.245), and recurrence rates (5.6 per cent versus 5.1 per cent; P > 0.009) were similar. Conclusion: Patients with ventral incisional hernias who undergo bilateral rTAR had significantly shorter postoperative hospital stays and fewer short-term complications compared with patients undergoing bilateral oTAR.
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- 2022
19. Preoperative hemoglobin count and prognosis of esophageal cancer, a population-based nationwide study in Finland
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Jokela, E. M. (Ella M.K.), Kauppila, J. H. (Joonas H.), Helminen, O. (Olli), Helmiö, M. (Mika), Huhta, H. (Heikki), Kallio, R. (Raija), Koivukangas, V. (Vesa), Kokkola, A. (Arto), Laine, S. (Simo), Lietzen, E. (Elina), Meriläinen, S. (Sanna), Ohtonen, P. (Pasi), Pohjanen, V.-M. (Vesa-Matti), Rantanen, T. (Tuomo), Ristimäki, A. (Ari), Räsänen, J. V. (Jari V.), Saarnio, J. (Juha), Sihvo, E. (Eero), Toikkanen, V. (Vesa), Tyrväinen, T. (Tuula), Valtola, A. (Antti), Jokela, E. M. (Ella M.K.), Kauppila, J. H. (Joonas H.), Helminen, O. (Olli), Helmiö, M. (Mika), Huhta, H. (Heikki), Kallio, R. (Raija), Koivukangas, V. (Vesa), Kokkola, A. (Arto), Laine, S. (Simo), Lietzen, E. (Elina), Meriläinen, S. (Sanna), Ohtonen, P. (Pasi), Pohjanen, V.-M. (Vesa-Matti), Rantanen, T. (Tuomo), Ristimäki, A. (Ari), Räsänen, J. V. (Jari V.), Saarnio, J. (Juha), Sihvo, E. (Eero), Toikkanen, V. (Vesa), Tyrväinen, T. (Tuula), and Valtola, A. (Antti)
- Abstract
Background: The prognostic value of preoperative hemoglobin in patients undergoing esophagectomy is unknown. The aim of this study was to examine whether preoperative hemoglobin is associated with prognosis in patients undergoing esophagectomy for cancer. Materials and methods: This was a population-based nationwide retrospective cohort study in Finland, using Finnish National Esophago-Gastric Cancer Cohort (FINEGO). Esophagectomy patients with available preoperative hemoglobin measurement were included. Multivariable cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for calendar period of surgery, age at surgery, sex, comorbidity (Charlson Comorbidity Index), tumor histology, tumor stage, neoadjuvant therapy, type of surgery (minimally invasive or open) and annual hospital volume. Results: Of the 1313 patients, 932 (71.0%) were men and 799 (60.9%) had esophageal adenocarcinoma. Overall all-cause mortality was significantly higher in the lowest hemoglobin count tertile (HR 1.26 (1.07–1.47)) compared to the highest tertile, but this association was attenuated after adjustment for confounding. No differences were found between the preoperative hemoglobin groups in the adjusted analyses of 90-day all-cause, 5-year all-cause, and 5-year cancer-specific mortality. Conclusions: In this population-based nationwide study, preoperative hemoglobin count had no independent prognostic significance in esophageal cancer.
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- 2022
20. Sarcopenia and myosteatosis are associated with neutrophil to lymphocyte ratio but not Glasgow prognostic score in colorectal cancer patients
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Aro, R. (Raila), Meriläinen, S. (Sanna), Sirniö, P. (Päivi), Väyrynen, J. P. (Juha P.), Pohjanen, V.-M. (Vesa-Matti), Herzig, K.-H. (Karl-Heinz), Rautio, T. T. (Tero T.), Mäkäräinen, E. (Elisa), Häivälä, R. (Reetta), Klintrup, K. (Kai), Mäkinen, M. J. (Markus J.), Saarnio, J. (Juha), Tuomisto, A. (Anne), Aro, R. (Raila), Meriläinen, S. (Sanna), Sirniö, P. (Päivi), Väyrynen, J. P. (Juha P.), Pohjanen, V.-M. (Vesa-Matti), Herzig, K.-H. (Karl-Heinz), Rautio, T. T. (Tero T.), Mäkäräinen, E. (Elisa), Häivälä, R. (Reetta), Klintrup, K. (Kai), Mäkinen, M. J. (Markus J.), Saarnio, J. (Juha), and Tuomisto, A. (Anne)
- Abstract
Cancer patients commonly present sarcopenia, myosteatosis, and systemic inflammation, which are risk factors of poor survival. In this study, sarcopenia and myosteatosis were defined from preoperative body computed tomography scans of 222 colorectal cancer (CRC) patients and analyzed in relation to tumor and patient characteristics, markers of systemic inflammation (modified Glasgow prognostic score (mGPS), neutrophil–lymphocyte ratio (NLR), serum levels of C-reactive protein (CRP), albumin, and 13 cytokines, and survival. Of the systemic inflammation markers, sarcopenia and/or myosteatosis associated with elevated NLR (p = 0.005) and low albumin levels (≤35 g/L) (p = 0.018), but not with mGPS or serum cytokine levels. In addition, myosteatosis was associated with a proximal tumor location (p = 0.039), serrated tumor subtype (p < 0.001), and severe comorbidities (p = 0.004). Multivariable analyses revealed that severe comorbidities and serrated histology were independent predictors of myosteatosis, and older age and elevated NLR were independent indicators of sarcopenia. Myosteatosis associated with shorter overall survival in univariable analysis (HR 1.959, 95% CI 1.24–3.10, p = 0.004) but not in multivariable analysis (p = 0.075). We conclude that sarcopenia and myosteatosis were associated with inflammatory marker NLR, but not with mGPS. Moreover, patients with serrated CRC may have an increased risk of myosteatosis. Myosteatosis or sarcopenia were not independent predictors of patient survival.
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- 2022
21. Effect of surface tooling techniques of medical titanium implants on bacterial biofilm formation in vitro
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Sarfraz, S. (Sonia), Mäntynen, P.-h. (Pilvi-helinä), Laurila, M. (Marisa), Suojanen, J. (Juho), Saarnio, J. (Juha), Rossi, S. (Sami), Horelli, J. (Jani), Kaakinen, M. (Mika), Leikola, J. (Junnu), Reunanen, J. (Justus), Sarfraz, S. (Sonia), Mäntynen, P.-h. (Pilvi-helinä), Laurila, M. (Marisa), Suojanen, J. (Juho), Saarnio, J. (Juha), Rossi, S. (Sami), Horelli, J. (Jani), Kaakinen, M. (Mika), Leikola, J. (Junnu), and Reunanen, J. (Justus)
- Abstract
The aim of this study was to assess the biofilm formation of Streptococcus mutans, Staphylococcus aureus, Enterococcus faecalis, and Escherichia coli on titanium implants with CAD-CAM tooling techniques. Twenty specimens of titanium were studied: Titanium grade 2 tooled with a Planmeca CAD-CAM milling device (TiGrade 2), Ti₆Al₄V grade 5 as it comes from CAD-DMLS device (computer aided design-direct metal laser sintering device) (TiGrade 5), Ti₆Al₄V grade 23 as it comes from a CAD-CAM milling device (TiGrade 23), and CAD-DMLS TiGrade 5 polished with an abrasive disc (TiGrade 5 polished). Bacterial adhesion on the implants was completed with and without saliva treatment to mimic both extraoral and intraoral surgical methods of implant placement. Five specimens/implant types were used in the bacterial adhesion experiments. Autoclaved implant specimens were placed in petri plates and immersed in saliva solution for 30 min at room temperature and then washed 3× with 1× PBS. Bacterial suspensions of each strain were made and added to the specimens after saliva treatment. Biofilm was allowed to form for 24 h at 37 °C and the adhered bacteria was calculated. Tooling techniques had an insignificant effect on the bacterial adhesion by all the bacterial strains studied. However, there was a significant difference in biofilm formation between the saliva-treated and non-saliva-treated implants. Saliva contamination enhanced S. mutans, S. aureus, and E. faecalis adhesion in all material types studied. S. aureus was found to be the most adherent strain in the saliva-treated group, whereas E. coli was the most adherent strain in the non-saliva-treated group. In conclusion, CAD-CAM tooling techniques have little effect on bacterial adhesion. Saliva coating enhances the biofilm formation; therefore, saliva contamination of the implant must be minimized during implant placement. Further extensive studies are needed to evaluate the effects of surface treatments of the titanium
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- 2022
22. Carbonic anhydrases II, IX, and XII in reflux esophagitis
- Author
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Nortunen, M. (Minna), Väkiparta, N. (Nina), Parkkila, S. (Seppo), Saarnio, J. (Juha), Huhta, H. (Heikki), Karttunen, T. J. (Tuomo J.), Nortunen, M. (Minna), Väkiparta, N. (Nina), Parkkila, S. (Seppo), Saarnio, J. (Juha), Huhta, H. (Heikki), and Karttunen, T. J. (Tuomo J.)
- Abstract
Background: The pathogenesis of gastroesophageal reflux disease (GERD) has not been resolved in detail. Esophageal epithelial cells provide resistance to acidic reflux via several mechanisms, many of which involve buffering acid with bicarbonate and transporting protons. Carbonic anhydrases (CAs) are enzymes that control the acid–base balance by catalyzing the reversible hydration of carbon dioxide to produce bicarbonate and hydrogen ions. Aims: We aimed to determine the immunohistochemical expression patterns of CAII, CAIX, and CAXII in the normal esophageal squamous epithelium and in patients with GERD. Methods: We evaluated 82 biopsy samples, including 26 with a histologically normal esophagus, 26 with histologically mild esophagitis, and 30 with severe esophagitis. Expression patterns of CAII, CAIX, and CAXII in the esophageal squamous epithelium were determined by immunohistochemical staining. Results: Cytoplasmic CAII expression was predominantly detected in the upper luminal part of the squamous epithelium and was significantly (p < 0.01) increased in GERD. Expression of CAIX was essentially membranous. The isozyme was constantly present in the peripapillary cells. In the interpapillary areas, clustered expression was observed to emerge and increase significantly (p < 0.01) in esophagitis. CAXII expression was the most abundant of the isozymes and was mainly membranous. In the normal squamous epithelium, CAXII expression was confined to the basal layer; in severe esophagitis, CAXII expression increased significantly in both basal (p < 0.05) and superficial (p < 0.01) halves of the epithelium. Conclusions: We demonstrate upregulated expression of CAII, CAIX, and CAXII in GERD. The increase in expression likely contributes to esophageal epithelial resistance to acidic reflux.
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- 2022
23. Prophylactic retrorectus mesh versus no mesh in midline emergency laparotomy closure for prevention of incisional hernia (PREEMER):study protocol for a multicentre, double-blinded, randomized controlled trial
- Author
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Mäkäräinen, E. (Elisa), Tolonen, M. (Matti), Sallinen, V. (Ville), Mentula, P. (Panu), Leppäniemi, A. (Ari), Ahonen-Siirtola, M. (Mirella), Saarnio, J. (Juha), Ohtonen, P. (Pasi), Muysoms, F. (Filip), Rautio, T. (Tero), Mäkäräinen, E. (Elisa), Tolonen, M. (Matti), Sallinen, V. (Ville), Mentula, P. (Panu), Leppäniemi, A. (Ari), Ahonen-Siirtola, M. (Mirella), Saarnio, J. (Juha), Ohtonen, P. (Pasi), Muysoms, F. (Filip), and Rautio, T. (Tero)
- Abstract
Background: Despite the fact that emergency midline laparotomy is a risk factor for an incisional hernia, active research on hernia prevention in emergency settings is lacking. Different kinds of meshes and mesh positions have been studied in elective abdominal surgery, but no randomized controlled trials in emergency settings have been published thus far. Methods: The PREEMER trial (registration number NCT04311788) is a multicentre, patient- and assessor-blinded, randomized controlled trial to be conducted in six hospitals in Finland. A total of 244 patients will be randomized at a 1 : 1 ratio to either the retrorectus mesh group, featuring a self-gripping prophylactic mesh, or to the no mesh (control) group, both closed by small-stitch 4 : 1 closure with continuous slowly absorbable monofilament suturing. The primary outcome of the PREEMER trial is the incidence of incisional hernia 2 years after surgery, which will be detected clinically and/or radiologically. Secondary outcomes are the Comprehensive Complication Index score, incidence of surgical-site infections and fascial dehiscence within 30 days of surgery; the incisional hernia repair rate and mesh- or hernia-related reoperations within the 2- and 5-year follow-ups; the incidence of incisional hernia within the 5-year follow-up; and quality of life measured by RAND-36, the Activities Assessment Scale and the PROMIS questionnaire within 30 days and 2 and 5 years from surgery. Additionally, health–economic explorative measures will be explored. Conclusions: The PREEMER trial will provide level 1 evidence on incisional hernia prevention in an emergency setting. Registration number: NCT04311788 (http://www.clinicaltrials.gov). Registered 7 March 2020
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- 2022
24. Textbook outcome following oesophagectomy for cancer: international cohort study
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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
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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.
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- 2022
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25. Histological Damage of Colonic Epithelium is Associated with Clinical Severity and Outcome in Colectomized Critically Ill Patients
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Sipola, S., Ala-Kokko, T. I., Laurila, J. J., Vakkala, M., Ohtonen, P., Saarnio, J., Karttunen, T. J., and Syrjälä, H.
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- 2014
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26. Treatment of esophageal perforation in octogenarians: a multicenter study
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Biancari, F., Gudbjartsson, T., Mennander, A., Hypén, L., Salminen, P., Kuttila, K., Viktorzon, M., Böckelman, C., Tarantino, E., Tiffet, O., Koivukangas, V., Sreide, J. A., Viste, A., Bonavina, L., Vidarsdottir, H. H., and Saarnio, J.
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- 2014
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27. Postoperative and Pathological Outcomes of CROSS and FLOT as Neoadjuvant Therapy for Esophageal and Junctional Adenocarcinoma
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Committee:, Steering, Alderson, D, Bundred, J, RPT, Evans, Gossage, J, Griffiths, EA, Jefferies, B, Kamarajah, SK, McKay, S, Mohamed, Nepogodiev, D, Siaw- Acheampong, K, Singh, P, van Hillegersberg, R, Vohra, R, Wanigasooriya, K, Whitehouse, T., Leads:, National, Gjata, A, Moreno, JI, Takeda, FR, Kidane, B, Guevara Castro, R, Harustiak, T, Bekele, A, Kechagias, A, Gockel, 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, Blanco, R, Wallner, B, Schneider, PM, Hsu, PK, Isik, A, Leads:, Site, Gananadha, S, Wills, 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, 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, Hedberg, J, Mönig, S, Gutknecht, S, Tez, M, Guner, A, Tirnaksiz, MB, Colak, E, Sevinç, B, Hindmarsh, A, Khan, 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, RAA, Sallum, da Rocha, JRM, Lopes, LR, Tercioti, V, 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, 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, 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, Mendola, La, 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, 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, Cordos, Birla, RD, Predescu, D, Hoara, PA, Tomsa, R, Shneider, Agasiev, M, Ganjara, Gunjić, D, Veselinović, M, Babič, T, Chin, TS, Shabbir, A, Kim, G, Crnjac, A, Samo, H, Val, Díez del, 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, Martín, Concepción, 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, 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, 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, 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, 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.
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- 2023
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28. International Variation in Surgical Practices in Units Performing Oesophagectomy for Oesophageal Cancer: A Unit Survey from the Oesophago-Gastric Anastomosis Audit (OGAA)
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Bundred, J. R., Kamarajah, S. K., Siaw-Acheampong, K., Nepogodiev, D., Jefferies, B., Singh, P., Evans, R., Griffiths, E. A., Alderson, D., Gossage, J., Mckay, S., Mohamed, I., van Hillegersberg, R., Vohra, R., Wanigsooriya, K., Whitehouse, T., Bagajevas, A., Bekele, A., Blanco-Colino, R., Da Roit, A., El Kafsi-Mawley, J., Gjata, A., Gockel, I., Castro, R. G., Harustiak, T., Hsu, P. -K., Isik, A., Kechagias, A., Kennedy, A., Kidane, B., Mahendran, H. A., Mejia, L., Moreno, J. I., Negoi, I., Santiago, A. J., Sayyed, R., Schneider, P., Soares, A. S., Sousa, M., Takeda, F. R., Vanstraten, S., Wallner, B., Wijnhoven, B., Achiam, M., Agustin, T., Akbar, A., Al-Bahrani, A., Al-Khyatt, W., Albertsmeier, M., Alghunaim, E., Alkhaffaf, B., Allum, W., Am, F., Andreollo, N., Arndt, A., Babor, R., Barbosa, J., Bardini, R., Beardsmore, D., Beban, G., Bernardes, A., Berrisford, R., Bianchi, A., Bjelovic, M., Boddy, A., Bolca, C., Bonavina, L., Bryce, G., Byrom, R., Casaca, R., Chan, D., Charalabopoulos, A., Cheong, E., Ciotola, F., Colak, E., Collins, C., Constantinoiu, S., Costa, R., Dahlke, M., Darling, G., Dawas, K., de Manzoni, G., Denewer, A., Devadas, M., Dexter, S., Dikinis, S., Dimitrios, T., Dolan, J., Duong, C., Egberts, J. -H., Elgharably, Y., Elhadi, M., Elmahi, S., Farias, F. A., Fekaj, E., Fernandez, J., Forshaw, M., Freire, J., French, D., Gacevski, G., Gaedcke, J., Gananadha, S., Gijon, M. M., Gokhale, J., Gordon, A., Grimminger, P., Guevara, R., Guner, A., Gutknecht, S., Mahmoodzadeh, H., Halldestam, I., Hedberg, J., Heisterkamp, J., Higgs, S., Hii, M., Hindmarsh, A., Hoppner, J., Isaza, A., Izbicki, J., Jacobs, R., Jain, P., Johansson, J., Johnston, B., Kafsi, J., Kassa, S., Kelty, C., Khan, I., Khoo, D., Khyatt, S., Kjaer, D., Korkolis, D., Kreuser, N., Larsen, M., Lau, P., Leite, J., Lewis, W., Liakakos, T., Loureiro, C., Mahendran, A., Maynard, N., Mcgregor, R., Mcnally, S., Medina-Franco, H., Meguid, R., Melhado, R., Mercer, S., Migliore, M., Mingol, F., Mogoanta, S., Mohri, Y., Monig, S., Moreno, J., Motas, N., Murphy, T., Naqi, S., Ni, R., Niazi, S., Oglesby, S., Okonta, K., Ortiz, S. R., Pal, K., Palazzo, F., Pascher, A., Pascual, M., Pata, G., Pera, M., Puig, S., Ramirez, J., Raptis, D., Rasanen, J., Reim, D., Reynolds, J., Robb, W., Robertson, K., Rosero, G., Rosman, C., Rossaak, J., Saarnio, J., Santiago, A., Schiesser, M., Scurtu, R. -R., Sekhniaidze, D., Sevinc, B., Skipworth, R., So, J., Trugeda, M. S., Syed, A., Takahashi, A. M. L., Takeda, F., Talbot, M., Tareen, M., Terashima, M., Testini, M., Tewari, N., Tez, M., Thomas, M., Tirnaksiz, M., Tonini, V., C. -C., Tu, Turner, P., Underwood, T., Uzair, A., Vallve-Bernal, M., Valmasoni, M., Vicente, C., Videira, J. F., Viswanath, Y., Weindelmayer, J., White, R., Wigle, D., Wilkerson, P., Wills, V., Zacharakis, E., Zuluaga, M., Surgery, Moenig, Stefan Paul, Bundred J.R., Kamarajah S.K., Siaw-Acheampong K., Nepogodiev D., Jefferies B., Singh P., Evans R., Griffiths E.A., Alderson D., Gossage J., McKay S., Mohamed I., van Hillegersberg R., Vohra R., Wanigsooriya K., Whitehouse T., Bagajevas A., Bekele A., Blanco-Colino R., Da Roit A., El Kafsi-Mawley J., Gjata A., Gockel I., Castro R.G., Harustiak T., Hsu P.-K., Isik A., Kechagias A., Kennedy A., Kidane B., Mahendran H.A., Mejia L., Moreno J.I., Negoi I., Santiago A.J., Sayyed R., Schneider P., Soares A.S., Sousa M., Takeda F.R., Vanstraten S., Wallner B., Wijnhoven B., Achiam M., Agustin T., Akbar A., Al-Bahrani A., Al-Khyatt W., Albertsmeier M., Alghunaim E., Alkhaffaf B., Allum W., Am F., Andreollo N., Arndt A., Babor R., Barbosa J., Bardini R., Beardsmore D., Beban G., Bernardes A., Berrisford R., Bianchi A., Bjelovic M., Boddy A., Bolca C., Bonavina L., Bryce G., Byrom R., Casaca R., Chan D., Charalabopoulos A., Cheong E., Ciotola F., Colak E., Collins C., Constantinoiu S., Costa R., Dahlke M., Darling G., Dawas K., de Manzoni G., Denewer A., Devadas M., Dexter S., Dikinis S., Dimitrios T., Dolan J., Duong C., Egberts J.-H., Elgharably Y., Elhadi M., Elmahi S., Farias F.A., Fekaj E., Fernandez J., Forshaw M., Freire J., French D., Gacevski G., Gaedcke J., Gananadha S., Gijon M.M., Gokhale J., Gordon A., Grimminger P., Guevara R., Guner A., Gutknecht S., Mahmoodzadeh H., Halldestam I., Hedberg J., Heisterkamp J., Higgs S., Hii M., Hindmarsh A., Hoppner J., Isaza A., Izbicki J., Jacobs R., Jain P., Johansson J., Johnston B., Kafsi J., Kassa S., Kelty C., Khan I., Khoo D., Khyatt S., Kjaer D., Korkolis D., Kreuser N., Larsen M., Lau P., Leite J., Lewis W., Liakakos T., Loureiro C., Mahendran A., Maynard N., Mcgregor R., Mcnally S., Medina-Franco H., Meguid R., Melhado R., Mercer S., Migliore M., Mingol F., Mogoanta S., Mohri Y., Monig S., Moreno J., Motas N., Murphy T., Naqi S., Ni R., Niazi S., Oglesby S., Okonta K., Ortiz S.R., Pal K., Palazzo F., Pascher A., Pascual M., Pata G., Pera M., Puig S., Ramirez J., Raptis D., Rasanen J., Reim D., Reynolds J., Robb W., Robertson K., Rosero G., Rosman C., Rossaak J., Saarnio J., Santiago A., Schiesser M., Scurtu R.-R., Sekhniaidze D., Sevinc B., Skipworth R., So J., Trugeda M.S., Syed A., Takahashi A.M.L., Takeda F., Talbot M., Tareen M., Terashima M., Testini M., Tewari N., Tez M., Thomas M., Tirnaksiz M., Tonini V., Tu C.-C., Turner P., Underwood T., Uzair A., Vallve-Bernal M., Valmasoni M., Vicente C., Videira J.F., Viswanath Y., Weindelmayer J., White R., Wigle D., Wilkerson P., Wills V., Zacharakis E., and Zuluaga M.
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Leak ,medicine.medical_specialty ,Internationality ,Oesophagectomy , Oesophageal Cancer: Oesophago-Gastric Anastomosis ,complications ,Esophageal Neoplasms ,Anastomosis ,Anastomotic Leak ,Audit ,Anastomosis, Surgical ,Developed Countries ,Developing Countries ,Drainage ,Esophagectomy ,Hospital Units ,Humans ,Stents ,Surveys and Questionnaires ,Enhanced Recovery After Surgery ,Unit (housing) ,03 medical and health sciences ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Anastomotic leaks ,Surgical ,medicine ,Journal Article ,Response rate (survey) ,medicine.diagnostic_test ,ddc:617 ,business.industry ,General surgery ,Cancer ,Interventional radiology ,medicine.disease ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Surgery ,business - Abstract
Background: Anastomotic leaks are associated with significant risk of morbidity, mortality and treatment costs after oesophagectomy. The aim of this study was to evaluate international variation in unit-level clinical practice and resource availability for the prevention and management of anastomotic leak following oesophagectomy.Method: The Oesophago-Gastric Anastomosis Audit (OGAA) is an international research collaboration focussed on improving the care and outcomes of patients undergoing oesophagectomy. Any unit performing oesophagectomy worldwide can register to participate in OGAA studies. An online unit survey was developed and disseminated to lead surgeons at each unit registered to participate in OGAA. High-income country (HIC) and low/middle-income country (LMIC) were defined according to the World Bank whilst unit volume were defined as < 20 versus 20-59 versus ≥60 cases/year in the unit.Results: Responses were received from 141 units, a 77% (141/182) response rate. Median annual oesophagectomy caseload was reported to be 26 (inter-quartile range 12-50). Only 48% (68/141) and 22% (31/141) of units had an Enhanced Recovery After Surgery (ERAS) program and ERAS nurse, respectively. HIC units had significantly higher rates of stapled anastomosis compared to LMIC units (66 vs 31%, p = 0.005). Routine post-operative contrast-swallow anastomotic assessment was performed in 52% (73/141) units. Stent placement and interventional radiology drainage for anastomotic leak management were more commonly available in HICs than LMICs (99 vs 59%, p < 0.001 and 99 vs 83%, p < 0.001).Conclusions: This international survey highlighted variation in surgical technique and management of anastomotic leak based on case volume and country income level. Further research is needed to understand the impact of this variation on patient outcomes.
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- 2019
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29. Pathophysiology of reflux oesophagitis:role of Toll-like receptors 2 and 4 and Farnesoid X receptor
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Nortunen, M. (Minna), Väkiparta, N. (Nina), Porvari, K. (Katja), Saarnio, J. (Juha), Karttunen, T. J. (Tuomo J.), and Huhta, H. (Heikki)
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Reflux oesophagitis ,FXR ,TLR2 ,TLR4 - Abstract
The pathogenesis of gastroesophageal reflux disease (GERD) is not fully understood. It involves the activation of mucosal immune-mediated and inflammatory responses. Toll-like receptors (TLR) 2 and TLR4 are pattern-recognition receptors of the innate immune system; they recognize microbial and endogenous ligands. Farnesoid X receptor (FXR) is a bile acid receptor that regulates the inflammatory response. We aimed to evaluate TLR2, TLR4 and FXR expression patterns in GERD. We re-evaluated 84 oesophageal biopsy samples according to the global severity (GS) score, including 26 cases with histologically normal oesophagus, 28 with histologically mild oesophagitis and 30 with severe oesophagitis. We used immunohistochemistry and in situ hybridization to assess the expression patterns of TLR2, TLR4 and FXR in oesophageal squamous cells. Immunohistochemistry showed that nuclear and cytoplasmic TLR2 was expressed predominantly in the basal layer of normal oesophageal epithelium. In oesophagitis, TLR2 expression increased throughout the epithelium, and the superficial expression was significantly more intensive compared to normal epithelium, p
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- 2021
30. Mortality from esophagectomy for esophageal cancer across low, middle, and high-income countries: An international cohort study
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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.
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- 2021
31. Postoperative outcomes in oesophagectomy with trainee involvement
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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
32. Mortality from esophagectomy for esophageal cancer across low, middle, and high-income countries: An international cohort study
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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 and 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
- 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 Else
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- 2021
33. Postoperative outcomes in oesophagectomy with trainee involvement
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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. and 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.
- 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 oesophagect
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- 2021
34. Treatment trends and outcomes of hepatocellular carcinoma in a single center for 35 years
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Kairaluoma, V. (Valtteri), Karjalainen, M. (Mira), Pohjanen, V.-M. (Vesa-Matti), Saarnio, J. (Juha), Niemelä, J. (Jarmo), Huhta, H. (Heikki), Helminen, O. (Olli), Kairaluoma, V. (Valtteri), Karjalainen, M. (Mira), Pohjanen, V.-M. (Vesa-Matti), Saarnio, J. (Juha), Niemelä, J. (Jarmo), Huhta, H. (Heikki), and Helminen, O. (Olli)
- Abstract
Background: Hepatocellular carcinoma (HCC) is one of the leading causes of cancer mortality. The aim of this study was to examine the trends of HCC treatment and the outcomes in a single tertiary center for 35 years. Methods: Two hundred seventy–three consecutive HCC patients between 1983–2018 were identified from Oulu University Hospital records. Primary outcomes of the study were postoperative complications within 30 days after the operation, and short– (30–and 90–day) and long-term (1, 3 and 5–year) survival. Results: Of the 273 patients, 49 underwent surgical resection, 25 local ablation, 48 angiological treatment and 151 had palliative treatment. The rate of surgery declined over time, while other invasive treatments increased. Major complications occurred in 14 (28.6%) patients after surgical resection, in 2 (8.0%) patients after local ablation and in 13 (27.1%) patients after angiological treatment (P=0.022). Recurrence and local recidives were observed especially in local ablation group and in angiological treatment group (P<0.001). Overall survival rates in surgical resection group were at 30 and 90 days, 1–, 3– and 5–years 95.9%, 95.9%, 85.1%, 59.0% and 51.2%. In local ablation group, respective overall survival rates were 100.0%, 100.0%, 86.1%, 43.1% and 18.8%, and in angiological group 95.8%, 93.6%, 56.1%, 26.3% and 6.6%. In cox regression model adjusted for confounding factors, mortality hazard was lowest after surgical resection. Prognosis was poor in palliative group. Conclusions: Based on this Northern Finland population, the surgical resection of HCC has acceptable complication rate compared to other treatments; and yields the best long-term survival. Overall prognosis of HCC remains poor.
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- 2021
35. Minimally invasive esophagectomy learning curves with different types of background experience
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Helminen, O. (Olli), Kauppila, J. H. (Joonas H.), Saviaro, H. (Henna), Yannopoulos, F. (Fredrik), Meriläinen, S. (Sanna), Koivukangas, V. (Vesa), Huhta, H. (Heikki), Mrena, J. (Johanna), Saarnio, J. (Juha), Sihvo, E. (Eero), Helminen, O. (Olli), Kauppila, J. H. (Joonas H.), Saviaro, H. (Henna), Yannopoulos, F. (Fredrik), Meriläinen, S. (Sanna), Koivukangas, V. (Vesa), Huhta, H. (Heikki), Mrena, J. (Johanna), Saarnio, J. (Juha), and Sihvo, E. (Eero)
- Abstract
Background: Minimally invasive esophagectomy (MIE) is a complex procedure with learning associated morbidity. The aim was to evaluate the learning curve for MIE focusing on short-term outcomes in two settings: (I) experienced MIE surgeon in new hospital (Hospital 1); (II) surgeons experienced with open esophagectomy and minimally invasive surrogate surgery (Hospital 2). Methods: In Hospital 1 and Hospital 2, on intent-to-treat basis number of MIEs were 132 and 57, respectively. The primary outcomes were major complications and anastomosis leaks. Secondary outcomes were operative time, blood loss, lymph node yield, hospital stay and 1-year mortality. Length of learning curves were analyzed with risk-adjusted cumulative sum (RA-CUSUM) method. Results: In Hospital 1, major complication and anastomosis leak rates were 9.8% and 4.5%, 22.8% and 12.3% in Hospital 2, respectively. In Hospital 1, complication and leak rates remained stable. In Hospital 2, improvement occurred after 34 cases in major complications and 29 cases in leaks. Of secondary outcomes, improvements were seen in Hospital 1 in operative time after 61, blood loss after 86, lymph node yield after 52, hospital stay after 19 and 1-year mortality after 24 cases. In Hospital 2, improvement occurred in operative time after 30, blood loss after 15, lymph node yield after 45, hospital stay after 50 and 1-year mortality after 15 cases. Conclusions: According to this study, learning phase of the individual surgeon determines the outcomes of MIE, not the institutional learning phase.
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- 2021
36. Postoperative outcomes in oesophagectomy with trainee involvement
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Evans, R. P. (R. P. T.), Hodson, J. (J.), Kamarajah, S. K. (S. K.), Griffiths, E. A. (E. A.), Singh, P. (P.), Alderson, D. (D.), Bundred, J. (J.), Gossage, J. (J.), Jefferies, B. (B.), McKay, S. (S.), Mohamed, I. (I), Nepogodiev, D. (D.), Siaw-Acheampong, K. (K.), van Hillegersberg, R. (R.), Vohra, R. (R.), Wanigasooriya, K. (K.), Whitehouse, T. (T.), Gjata, A. (A.), Moreno, J. I. (J., I), Takeda, F. R. (F. R.), Kidane, B. (B.), Castro, R. G. (R. Guevara), Harustiak, T. (T.), Bekele, A. (A.), Kechagias, A. (A.), Gockel, I. (I), Kennedy, A. (A.), Da Roit, A. (A.), Bagajevas, A. (A.), Azagra, J. S. (J. S.), Mahendran, H. A. (H. A.), Mejia-Fernandez, L. (L.), Wijnhoven, B. P. (B. P. L.), El Kafsi, J. (J.), Sayyed, R. H. (R. H.), Sousa, M. (M.), Sampaio, A. S. (A. S.), Negoi, I. (I), Blanco, R. (R.), Wallner, B. (B.), Schneider, P. M. (P. M.), Hsu, P. K. (P. K.), Isik, A. (A.), Gananadha, S. (S.), Wills, V. (V), Devadas, M. (M.), Duong, C. (C.), Talbot, M. (M.), Hii, M. W. (M. W.), Jacobs, R. (R.), Andreollo, N. A. (N. A.), Johnston, B. (B.), Darling, G. (G.), Isaza-Restrepo, A. (A.), Rosero, G. (G.), Arias-Amezquita, F. (F.), Raptis, D. (D.), Gaedcke, J. (J.), Reim, D. (D.), Izbicki, J. (J.), Egberts, J. H. (J. H.), Dikinis, S. (S.), Kjaer, D. W. (D. W.), Larsen, M. H. (M. H.), Achiam, M. P. (M. P.), Saarnio, J. (J.), Theodorou, D. (D.), Liakakos, T. (T.), Korkolis, D. P. (D. P.), Robb, W. B. (W. B.), Collins, C. (C.), Murphy, T. (T.), Reynolds, J. (J.), Tonini, V. (V), Migliore, M. (M.), Bonavina, L. (L.), Valmasoni, M. (M.), Bardini, R. (R.), Weindelmayer, J. (J.), Terashima, M. (M.), White, R. E. (R. E.), Alghunaim, E. (E.), Elhadi, M. (M.), Leon-Takahashi, A. M. (A. M.), Medina-Franco, H. (H.), Lau, P. C. (P. C.), Okonta, K. E. (K. E.), Heisterkamp, J. (J.), Rosman, C. (C.), Beban, G. (G.), Babor, R. (R.), Gordon, A. (A.), Rossaak, J. I. (J., I), Pal, K. M. (K. M., I), Qureshi, A. U. (A. U.), Naqi, S. A. (S. A.), Syed, A. A. (A. A.), Barbosa, J. (J.), Vicente, C. S. (C. S.), Leite, J. (J.), Freire, J. (J.), Casaca, R. (R.), Costa, R. C. (R. C. T.), Scurtu, R. R. (R. R.), Mogoanta, S. S. (S. S.), Bolca, C. (C.), Constantinoiu, S. (S.), Sekhniaidze, D. (D.), So, J. B. (J. B. Y.), Gacvski, G. (G.), Loureiro, C. (C.), Pera, M. (M.), Bianchi, A. (A.), Gijon, M. M. (M. Moreno), Fernandez, J. M. (J. Martin), Carrera, M. S. (M. S. Trugeda), Vallve-Bernal, M. (M.), Pascual, M. A. (M. A. Citores), Elmahi, S. (S.), Halldestam, I. (I), Hedberg, J. (J.), Monig, S. (S.), Gutknecht, S. (S.), Tez, M. (M.), Guner, A. (A.), Tirnaksiz, T. B. (T. B.), Colak, E. (E.), Sevinc, B. (B.), Hindmarsh, A. (A.), Khan, I. (I), Khoo, D. (D.), Byrom, R. (R.), Gokhale, J. (J.), Wilkerson, P. (P.), Jain, P. (P.), Chan, D. (D.), Robertson, K. (K.), Iftikhar, S. (S.), Skipworth, R. (R.), Forshaw, M. (M.), Higgs, S. (S.), Nijjar, R. (R.), Viswanath, Y. K. (Y. K. S.), Turner, P. (P.), Dexter, S. (S.), Boddy, A. (A.), Allum, W. H. (W. H.), Oglesby, S. (S.), Cheong, E. (E.), Beardsmore, D. (D.), Maynard, N. (N.), Berrisford, R. (R.), Mercer, S. (S.), Puig, S. (S.), Melhado, R. (R.), Kelty, C. (C.), Underwood, T. (T.), Dawas, K. (K.), Lewis, W. (W.), Al-Bahrani, A. (A.), Bryce, G. (G.), Thomas, M. (M.), Arndt, A. T. (A. T.), Palazzo, F. (F.), Meguid, R. A. (R. A.), Fergusson, J. (J.), Beenen, E. (E.), Mosse, C. (C.), Salim, J. (J.), Cheah, S. (S.), Wright, T. (T.), Cerdeira, M. P. (M. P.), McQuillan, P. (P.), Richardson, M. (M.), Liem, H. (H.), Spillane, J. (J.), Yacob, M. (M.), Albadawi, F. (F.), Thorpe, T. (T.), Dingle, A. (A.), Cabalag, C. (C.), Loi, K. (K.), Fisher, O. M. (O. M.), Ward, S. (S.), Read, M. (M.), Johnson, M. (M.), Bassari, R. (R.), Bui, H. (H.), Cecconello, I. (I), Sallum, R. A. (R. A. A.), da Rocha, J. R. (J. R. M.), Lopes, L. R. (L. R.), Tercioti, V. J. (V., Jr.), Coelho, J. D. (J. D. S.), Ferrer, J. A. (J. A. P.), Buduhan, G. (G.), Tan, L. (L.), Srinathan, S. (S.), Shea, P. (P.), Yeung, J. (J.), Allison, F. (F.), Carroll, P. (P.), Vargas-Barato, F. (F.), Gonzalez, F. (F.), Ortega, J. (J.), Nino-Torres, L. (L.), Beltran-Garcia, T. C. (T. C.), Castilla, L. (L.), Pineda, M. (M.), Bastidas, A. (A.), Gomez-Mayorga, J. (J.), Cortes, N. (N.), Cetares, C. (C.), Caceres, S. (S.), Duarte, S. (S.), Pazdro, A. (A.), Snajdauf, M. (M.), Faltova, H. (H.), Sevcikova, M. (M.), Mortensen, P. B. (P. B.), Katballe, N. (N.), Ingemann, T. (T.), Morten, B. (B.), Kruhlikava, I. (I), Ainswort, A. P. (A. P.), Stilling, N. M. (N. M.), Eckardt, J. (J.), Holm, J. (J.), Thorsteinsson, M. (M.), Siemsen, M. (M.), Brandt, B. (B.), Nega, B. (B.), Teferra, E. (E.), Tizazu, A. (A.), Kauppila, J. S. (J. S.), Koivukangas, V. (V), Meriläinen, S. (S.), Gruetzmann, R. (R.), Krautz, C. (C.), Weber, G. (G.), Golcher, H. (H.), Emons, G. (G.), Azizian, A. (A.), Ebeling, M. (M.), Niebisch, S. (S.), Kreuser, N. (N.), Albanese, G. (G.), Hesse, J. (J.), Volovnik, L. (L.), Boecher, U. (U.), Reeh, M. (M.), Triantafyllou, S. (S.), Schizas, D. (D.), Michalinos, A. (A.), Baili, E. (E.), Mpoura, M. (M.), Charalabopoulos, A. (A.), Manatakis, D. K. (D. K.), Balalis, D. (D.), Bolger, J. (J.), Baban, C. (C.), Mastrosimone, A. (A.), McAnena, O. (O.), Quinn, A. (A.), Suilleabhain, C. B. (C. B. O.), Hennessy, M. M. (M. M.), Ivanovski, I. (I.), Khizer, H. (H.), Ravi, N. (N.), Donlon, N. (N.), Cervellera, M. (M.), Vaccari, S. (S.), Bianchini, S. (S.), Sartarelli, L. (L.), Asti, E. (E.), Bernardi, D. (D.), Merigliano, S. (S.), Provenzano, L. (L.), Scarpa, M. (M.), Saadeh, L. (L.), Salmaso, B. (B.), De Manzoni, G. (G.), Giacopuzzi, S. (S.), La Mendola, R. (R.), De Pasqual, C. A. (C. A.), Tsubosa, Y. (Y.), Niihara, M. (M.), Irino, T. (T.), Makuuchi, R. (R.), Ishii, K. (K.), Mwachiro, M. (M.), Fekadu, A. (A.), Odera, A. (A.), Mwachiro, E. (E.), AlShehab, D. (D.), Ahmed, H. A. (H. A.), Shebani, A. O. (A. O.), Elhadi, A. (A.), Elnagar, F. A. (F. A.), Elnagar, H. F. (H. F.), Makkai-Popa, S. T. (S. T.), Wong, L. F. (L. F.), Yunrong, T. (T.), Thanninalai, S. (S.), Aik, H. C. (H. C.), Soon, P. W. (P. W.), Huei, T. J. (T. J.), Basave, H. N. (H. N. L.), Cortes-Gonzalez, R. (R.), Lagarde, S. M. (S. M.), van Lanschot, J. J. (J. J. B.), Cords, C. (C.), Jansen, W. A. (W. A.), Martijnse, I. (I), Matthijsen, R. (R.), Bouwense, S. (S.), Klarenbeek, B. (B.), Verstegen, M. (M.), van Workum, F. (F.), Ruurda, J. P. (J. P.), van der Veen, A. (A.), van den Berg, J. W. (J. W.), Evenett, N. (N.), Johnston, P. (P.), Patel, R. (R.), MacCormick, A. (A.), Young, M. (M.), Smith, B. (B.), Ekwunife, C. (C.), Memon, A. H. (A. H.), Shaikh, K. (K.), Wajid, A. (A.), Khalil, N. (N.), Haris, M. (M.), Mirza, Z. U. (Z. U.), Qudus, S. B. (S. B. A.), Sarwar, M. Z. (M. Z.), Shehzadi, A. (A.), Raza, A. (A.), Jhanzaib, M. H. (M. H.), Farmanali, J. (J.), Zakir, Z. (Z.), Shakeel, O. (O.), Nasir, I. (I), Khattak, S. (S.), Baig, M. (M.), Noor, M. A. (M. A.), Ahmed, H. H. (H. H.), Naeem, A. (A.), Pinho, A. C. (A. C.), da Silva, R. (R.), Bernardes, A. (A.), Campos, J. C. (J. C.), Matos, H. (H.), Braga, T. (T.), Monteiro, C. (C.), Ramos, P. (P.), Cabral, F. (F.), Gomes, M. P. (M. P.), Martins, P. C. (P. C.), Correia, A. M. (A. M.), Videira, J. F. (J. F.), Ciuce, C. (C.), Drasovean, R. (R.), Apostu, R. (R.), Paitici, S. (S.), Racu, A. E. (A. E.), Obleaga, C. V. (C., V), Beuran, M. (M.), Stoica, B. (B.), Ciubotaru, C. (C.), Negoita, V. (V), Cordos, I. (I), Birla, R. D. (R. D.), Predescu, D. (D.), Hoara, P. A. (P. A.), Tomsa, R. (R.), Shneider, V. (V), Agasiev, M. (M.), Ganjara, I. (I), Gunjic, D. (D.), Veselinovic, M. (M.), Babic, T. (T.), Chin, T. S. (T. S.), Shabbir, A. (A.), Kim, G. (G.), Crnjac, A. (A.), Samo, H. (H.), del Val, I. D. (I. Diez), Leturio, S. (S.), Ramon, J. M. (J. M.), Dal Cero, M. (M.), Rifa, S. (S.), Rico, M. (M.), Pomar, A. P. (A. Pagan), Corcoles, J. A. (J. A. Martinez), Miravalles, J. L. (J. L. Rodicio), Pais, S. A. (S. A.), Turienzo, S. A. (S. A.), Alvarez, L. S. (L. S.), Campos, P. V. (P., V), Rendo, A. G. (A. G.), Garcia, S. S. (S. S.), Santos, E. P. (E. P. G.), Martinez, E. T. (E. T.), Diaz, M. J. (M. J. Fernandez), Alvarez, C. M. (C. Magadan), Martin, V. C. (V. Concepcion), Lopez, C. D. (C. Diaz), Rodrigo, A. R. (A. Rosat), Sanchez, L. E. (L. E. Perez), Cuadrado, M. B. (M. Bailon), Carrasco, C. T. (C. Tinoco), Bhojwani, E. C. (E. Choolani), Sanchez, D. P. (D. P.), Ahmed, M. E. (M. E.), Dzhendov, T. (T.), Lindberg, F. (F.), Rutegard, M. (M.), Sundbom, M. (M.), Mickael, C. (C.), Colucci, N. (N.), Schnider, A. (A.), Er, S. (S.), Kurnaz, E. (E.), Turkyilmaz, S. (S.), Turkyilmaz, A. (A.), Yildirim, R. (R.), Baki, B. E. (B. E.), Akkapulu, N. (N.), Karahan, O. (O.), Damburaci, N. (N.), Hardwick, R. (R.), Safranek, P. (P.), Sujendran, V. (V), Bennett, J. (J.), Afzal, Z. (Z.), Shrotri, M. (M.), Chan, B. (B.), Exarchou, K. (K.), Gilbert, T. (T.), Amalesh, T. (T.), Mukherjee, D. (D.), Mukherjee, S. (S.), Wiggins, T. H. (T. H.), Kennedy, R. (R.), McCain, S. (S.), Harris, A. 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(N.), Palser, T. (T.), Hunter, D. (D.), Supramaniam, K. (K.), Butt, Z. (Z.), Ahmed, A. (A.), Kumar, S. (S.), Chaudry, A. (A.), Moussa, O. (O.), Kordzadeh, A. (A.), Patil, P. (P.), Noaman, I. (I), Willem, J. (J.), Bouras, G. (G.), Evans, R. (R.), Singh, M. (M.), Warrilow, H. (H.), Ahmad, A. (A.), Tewari, N. (N.), Yanni, F. (F.), Couch, J. (J.), Theophilidou, E. (E.), Reilly, J. J. (J. J.), van Boxel, G. (G.), Akbari, K. (K.), Zanotti, D. (D.), Sgromo, B. (B.), Sanders, G. (G.), Wheatley, T. (T.), Ariyarathenam, A. (A.), Reece-Smith, A. (A.), Humphreys, L. (L.), Choh, C. (C.), Carter, N. (N.), Knight, B. (B.), Pucher, P. (P.), Athanasiou, A. (A.), Tan, B. (B.), Abdulrahman, M. (M.), Vickers, J. (J.), Akhtar, K. (K.), Chaparala, R. (R.), Brown, R. (R.), Alasmar, M. M. (M. M. A.), Ackroyd, R. (R.), Patel, K. (K.), Tamhankar, A. (A.), Wyman, A. (A.), Walker, R. (R.), Grace, B. (B.), Abbassi, N. (N.), Slim, N. (N.), Ioannidi, L. (L.), Blackshaw, G. (G.), Havard, T. (T.), Escofet, X. (X.), Powell, A. (A.), Owera, A. (A.), Rashid, F. (F.), Jambulingam, P. (P.), Padickakudi, J. (J.), Ben-Younes, H. (H.), McCormack, K. (K.), Makey, I. A. (I. A.), Karush, M. K. (M. K.), Seder, C. W. (C. W.), Liptay, M. J. (M. J.), Chmielewski, G. (G.), Rosato, E. L. (E. L.), Berger, A. C. (A. C.), Zheng, R. (R.), Okolo, E. (E.), Singh, A. (A.), Scott, C. D. (C. D.), Weyant, M. J. (M. J.), Mitchell, J. D. (J. D.), Evans, R. P. (R. P. T.), Hodson, J. (J.), Kamarajah, S. K. (S. K.), Griffiths, E. A. (E. A.), Singh, P. (P.), Alderson, D. (D.), Bundred, J. (J.), Gossage, J. (J.), Jefferies, B. (B.), McKay, S. (S.), Mohamed, I. (I), Nepogodiev, D. (D.), Siaw-Acheampong, K. (K.), van Hillegersberg, R. (R.), Vohra, R. (R.), Wanigasooriya, K. (K.), Whitehouse, T. (T.), Gjata, A. (A.), Moreno, J. I. (J., I), Takeda, F. R. (F. R.), Kidane, B. (B.), Castro, R. G. (R. Guevara), Harustiak, T. (T.), Bekele, A. (A.), Kechagias, A. (A.), Gockel, I. (I), Kennedy, A. (A.), Da Roit, A. 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(T.), Dingle, A. (A.), Cabalag, C. (C.), Loi, K. (K.), Fisher, O. M. (O. M.), Ward, S. (S.), Read, M. (M.), Johnson, M. (M.), Bassari, R. (R.), Bui, H. (H.), Cecconello, I. (I), Sallum, R. A. (R. A. A.), da Rocha, J. R. (J. R. M.), Lopes, L. R. (L. R.), Tercioti, V. J. (V., Jr.), Coelho, J. D. (J. D. S.), Ferrer, J. A. (J. A. P.), Buduhan, G. (G.), Tan, L. (L.), Srinathan, S. (S.), Shea, P. (P.), Yeung, J. (J.), Allison, F. (F.), Carroll, P. (P.), Vargas-Barato, F. (F.), Gonzalez, F. (F.), Ortega, J. (J.), Nino-Torres, L. (L.), Beltran-Garcia, T. C. (T. C.), Castilla, L. (L.), Pineda, M. (M.), Bastidas, A. (A.), Gomez-Mayorga, J. (J.), Cortes, N. (N.), Cetares, C. (C.), Caceres, S. (S.), Duarte, S. (S.), Pazdro, A. (A.), Snajdauf, M. (M.), Faltova, H. (H.), Sevcikova, M. (M.), Mortensen, P. B. (P. B.), Katballe, N. (N.), Ingemann, T. (T.), Morten, B. (B.), Kruhlikava, I. (I), Ainswort, A. P. (A. P.), Stilling, N. M. (N. M.), Eckardt, J. (J.), Holm, J. (J.), Thorsteinsson, M. (M.), Siemsen, M. (M.), Brandt, B. (B.), Nega, B. (B.), Teferra, E. (E.), Tizazu, A. (A.), Kauppila, J. S. (J. S.), Koivukangas, V. (V), Meriläinen, S. (S.), Gruetzmann, R. (R.), Krautz, C. (C.), Weber, G. (G.), Golcher, H. (H.), Emons, G. (G.), Azizian, A. (A.), Ebeling, M. (M.), Niebisch, S. (S.), Kreuser, N. (N.), Albanese, G. (G.), Hesse, J. (J.), Volovnik, L. (L.), Boecher, U. (U.), Reeh, M. (M.), Triantafyllou, S. (S.), Schizas, D. (D.), Michalinos, A. (A.), Baili, E. (E.), Mpoura, M. (M.), Charalabopoulos, A. (A.), Manatakis, D. K. (D. K.), Balalis, D. (D.), Bolger, J. (J.), Baban, C. (C.), Mastrosimone, A. (A.), McAnena, O. (O.), Quinn, A. (A.), Suilleabhain, C. B. (C. B. O.), Hennessy, M. M. (M. M.), Ivanovski, I. (I.), Khizer, H. (H.), Ravi, N. (N.), Donlon, N. (N.), Cervellera, M. (M.), Vaccari, S. (S.), Bianchini, S. (S.), Sartarelli, L. (L.), Asti, E. (E.), Bernardi, D. (D.), Merigliano, S. (S.), Provenzano, L. (L.), Scarpa, M. (M.), Saadeh, L. (L.), Salmaso, B. (B.), De Manzoni, G. (G.), Giacopuzzi, S. (S.), La Mendola, R. (R.), De Pasqual, C. A. (C. A.), Tsubosa, Y. (Y.), Niihara, M. (M.), Irino, T. (T.), Makuuchi, R. (R.), Ishii, K. (K.), Mwachiro, M. (M.), Fekadu, A. (A.), Odera, A. (A.), Mwachiro, E. (E.), AlShehab, D. (D.), Ahmed, H. A. (H. A.), Shebani, A. O. (A. O.), Elhadi, A. (A.), Elnagar, F. A. (F. A.), Elnagar, H. F. (H. F.), Makkai-Popa, S. T. (S. T.), Wong, L. F. (L. F.), Yunrong, T. (T.), Thanninalai, S. (S.), Aik, H. C. (H. C.), Soon, P. W. (P. W.), Huei, T. J. (T. J.), Basave, H. N. (H. N. L.), Cortes-Gonzalez, R. (R.), Lagarde, S. M. (S. M.), van Lanschot, J. J. (J. J. B.), Cords, C. (C.), Jansen, W. A. (W. A.), Martijnse, I. (I), Matthijsen, R. (R.), Bouwense, S. (S.), Klarenbeek, B. (B.), Verstegen, M. (M.), van Workum, F. (F.), Ruurda, J. P. (J. P.), van der Veen, A. (A.), van den Berg, J. W. (J. W.), Evenett, N. (N.), Johnston, P. (P.), Patel, R. (R.), MacCormick, A. (A.), Young, M. (M.), Smith, B. (B.), Ekwunife, C. (C.), Memon, A. H. (A. H.), Shaikh, K. (K.), Wajid, A. (A.), Khalil, N. (N.), Haris, M. (M.), Mirza, Z. U. (Z. U.), Qudus, S. B. (S. B. A.), Sarwar, M. Z. (M. Z.), Shehzadi, A. (A.), Raza, A. (A.), Jhanzaib, M. H. (M. H.), Farmanali, J. (J.), Zakir, Z. (Z.), Shakeel, O. (O.), Nasir, I. (I), Khattak, S. (S.), Baig, M. (M.), Noor, M. A. (M. A.), Ahmed, H. H. (H. H.), Naeem, A. (A.), Pinho, A. C. (A. C.), da Silva, R. (R.), Bernardes, A. (A.), Campos, J. C. (J. C.), Matos, H. (H.), Braga, T. (T.), Monteiro, C. (C.), Ramos, P. (P.), Cabral, F. (F.), Gomes, M. P. (M. P.), Martins, P. C. (P. C.), Correia, A. M. (A. M.), Videira, J. F. (J. F.), Ciuce, C. (C.), Drasovean, R. (R.), Apostu, R. (R.), Paitici, S. (S.), Racu, A. E. (A. E.), Obleaga, C. V. (C., V), Beuran, M. (M.), Stoica, B. (B.), Ciubotaru, C. (C.), Negoita, V. (V), Cordos, I. (I), Birla, R. D. (R. D.), Predescu, D. (D.), Hoara, P. A. (P. A.), Tomsa, R. (R.), Shneider, V. (V), Agasiev, M. (M.), Ganjara, I. (I), Gunjic, D. (D.), Veselinovic, M. (M.), Babic, T. (T.), Chin, T. S. (T. S.), Shabbir, A. (A.), Kim, G. (G.), Crnjac, A. (A.), Samo, H. (H.), del Val, I. D. (I. Diez), Leturio, S. (S.), Ramon, J. M. (J. M.), Dal Cero, M. (M.), Rifa, S. (S.), Rico, M. (M.), Pomar, A. P. (A. Pagan), Corcoles, J. A. (J. A. Martinez), Miravalles, J. L. (J. L. Rodicio), Pais, S. A. (S. A.), Turienzo, S. A. (S. A.), Alvarez, L. S. (L. S.), Campos, P. V. (P., V), Rendo, A. G. (A. G.), Garcia, S. S. (S. S.), Santos, E. P. (E. P. G.), Martinez, E. T. (E. T.), Diaz, M. J. (M. J. Fernandez), Alvarez, C. M. (C. Magadan), Martin, V. C. (V. Concepcion), Lopez, C. D. (C. Diaz), Rodrigo, A. R. (A. Rosat), Sanchez, L. E. (L. E. Perez), Cuadrado, M. B. (M. Bailon), Carrasco, C. T. (C. Tinoco), Bhojwani, E. C. (E. Choolani), Sanchez, D. P. (D. P.), Ahmed, M. E. (M. E.), Dzhendov, T. (T.), Lindberg, F. (F.), Rutegard, M. (M.), Sundbom, M. (M.), Mickael, C. (C.), Colucci, N. (N.), Schnider, A. (A.), Er, S. (S.), Kurnaz, E. (E.), Turkyilmaz, S. (S.), Turkyilmaz, A. (A.), Yildirim, R. (R.), Baki, B. E. (B. E.), Akkapulu, N. (N.), Karahan, O. (O.), Damburaci, N. (N.), Hardwick, R. (R.), Safranek, P. (P.), Sujendran, V. (V), Bennett, J. (J.), Afzal, Z. (Z.), Shrotri, M. (M.), Chan, B. (B.), Exarchou, K. (K.), Gilbert, T. (T.), Amalesh, T. (T.), Mukherjee, D. (D.), Mukherjee, S. (S.), Wiggins, T. H. (T. H.), Kennedy, R. (R.), McCain, S. (S.), Harris, A. (A.), Dobson, G. (G.), Davies, N. (N.), Wilson, I. (I), Mayo, D. (D.), Bennett, D. (D.), Young, R. (R.), Manby, P. (P.), Blencowe, N. (N.), Schiller, M. (M.), Byrne, B. (B.), Mitton, D. (D.), Wong, V. (V), Elshaer, A. (A.), Cowen, M. (M.), Menon, V. (V), Tan, L. C. (L. C.), McLaughlin, E. (E.), Koshy, R. (R.), Sharp, C. (C.), Brewer, H. (H.), Das, N. (N.), Cox, M. (M.), Al Khyatt, W. (W.), Worku, D. (D.), Iqbal, R. (R.), Walls, L. (L.), McGregor, R. (R.), Fullarton, G. (G.), Macdonald, A. (A.), MacKay, C. (C.), Craig, C. (C.), Dwerryhouse, S. (S.), Hornby, S. (S.), Jaunoo, S. (S.), Wadley, M. (M.), Baker, C. (C.), Saad, M. (M.), Kelly, M. (M.), Davies, A. (A.), Di Maggio, F. (F.), Mistry, P. (P.), Singhal, R. (R.), Tucker, O. (O.), Kapoulas, S. (S.), Powell-Brett, S. (S.), Davis, P. (P.), Bromley, G. (G.), Watson, L. (L.), Verma, R. (R.), Ward, J. (J.), Shetty, V. (V), Ball, C. (C.), Pursnani, K. (K.), Sarela, A. (A.), Ling, H. S. (H. Sue), Mehta, S. (S.), Hayden, J. (J.), To, N. (N.), Palser, T. (T.), Hunter, D. (D.), Supramaniam, K. (K.), Butt, Z. (Z.), Ahmed, A. (A.), Kumar, S. (S.), Chaudry, A. (A.), Moussa, O. (O.), Kordzadeh, A. (A.), Patil, P. (P.), Noaman, I. (I), Willem, J. (J.), Bouras, G. (G.), Evans, R. (R.), Singh, M. (M.), Warrilow, H. (H.), Ahmad, A. (A.), Tewari, N. (N.), Yanni, F. (F.), Couch, J. (J.), Theophilidou, E. (E.), Reilly, J. J. (J. J.), van Boxel, G. (G.), Akbari, K. (K.), Zanotti, D. (D.), Sgromo, B. (B.), Sanders, G. (G.), Wheatley, T. (T.), Ariyarathenam, A. (A.), Reece-Smith, A. (A.), Humphreys, L. (L.), Choh, C. (C.), Carter, N. (N.), Knight, B. (B.), Pucher, P. (P.), Athanasiou, A. (A.), Tan, B. (B.), Abdulrahman, M. (M.), Vickers, J. (J.), Akhtar, K. (K.), Chaparala, R. (R.), Brown, R. (R.), Alasmar, M. M. (M. M. A.), Ackroyd, R. (R.), Patel, K. (K.), Tamhankar, A. (A.), Wyman, A. (A.), Walker, R. (R.), Grace, B. (B.), Abbassi, N. (N.), Slim, N. (N.), Ioannidi, L. (L.), Blackshaw, G. (G.), Havard, T. (T.), Escofet, X. (X.), Powell, A. (A.), Owera, A. (A.), Rashid, F. (F.), Jambulingam, P. (P.), Padickakudi, J. (J.), Ben-Younes, H. (H.), McCormack, K. (K.), Makey, I. A. (I. A.), Karush, M. K. (M. K.), Seder, C. W. (C. W.), Liptay, M. J. (M. J.), Chmielewski, G. (G.), Rosato, E. L. (E. L.), Berger, A. C. (A. C.), Zheng, R. (R.), Okolo, E. (E.), Singh, A. (A.), Scott, C. D. (C. D.), Weyant, M. J. (M. J.), and Mitchell, J. D. (J. D.)
- 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). Conclusions: 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.
- Published
- 2021
37. Carbonic anhydrases II, IX, and XII in esophageal and duodenal diseases
- Author
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Saarnio, J. (Juha), Karttunen, T. (Tuomo), Huhta, H. (Heikki), Nortunen, M. (Minna), Saarnio, J. (Juha), Karttunen, T. (Tuomo), Huhta, H. (Heikki), and Nortunen, M. (Minna)
- Abstract
Inflammatory and neoplastic diseases of the esophagus and duodenum cause a significant burden to healthcare and economies worldwide. Their etiology is multifactorial, but precursor lesions and risk factors are identifiable. Gastroesophageal reflux disease (GERD) is exceedingly common in western countries and causes the most medical health care expenses of all gastrointestinal diseases. GERD is the main risk factor for esophageal adenocarcinoma (EAC)––it can complicate into Barrett’s esophagus (BE) and further into esophageal adenocarcinoma. EAC has a poor overall prognosis still today, despite evolving management. High-quality prognostic biomarkers for EAC and progression of BE into cancer are lacking. Unlike esophageal diseases, nonampullary duodenal adenomas and adenocarcinoma (DAC) are rare neoplasias, although their incidence is slowly rising. In these rare diseases, the molecular pathological profiling is still incomplete, and the range of applicable prognostic biomarkers is very limited. Carbonic anhydrases (CA) are highly active, pH-controlling enzymes of the body. They participate in various physiological processes, but their primary function is to preserve optimal intra- and extracellular pH conditions in normal tissues. In cancer, CAII, CAIX, and CAXII seem to contribute to the development of malignant pH arrangement. The malignant pH gradient––slightly alkaline intracellular pH and extracellular acidosis––is in many ways critical to cancer progression, by benefiting cancer cell abilities to grow, migrate, invade, and metastasize. This study’s aim was to investigate the immunohistochemical expression patterns and potential roles of CAII, CAIX, and CAXII in the predisposing, premalignant and malignant conditions of distal esophagus and nonampullary duodenum. CA expression was evaluated in normal esophagus, GERD, Barrett’s esophagus, esophageal adenocarcinoma, normal duodenum, nonampullary duodenal adenomas and duodenal adenocarcinoma. The patient c, Tiivistelmä Ruokatorven ja pohjukaissuolen tulehdukselliset sairaudet ja kasvaimet aiheuttavat merkittäviä kustannuksia ja kuormittavat terveydenhuoltoa kaikkialla maailmassa. Näiden sairauksien etiologia on monitekijäinen, mutta hoidettavia esiasteita ja riskitekijöitä on tunnistettu ja niiden tutkiminen on potilaan hoidon ja ennusteen kannalta tärkeää. Ruokatorven refluksitauti on yleistynyt pitkään maailmanlaajuisesti. Sen hoito aiheuttaa nykyään suurimmat lääkehoidolliset kustannukset kaikista ruuansulatuskanavan sairauksista. Refluksitauti on myös ruokatorven adenokarsinooman merkittävin riskitekijä — Barrettin ruokatorvi on refluksitaudin komplikaatio ja ruokatorven adenokarsinooman esiaste. Ruokatorven adenokarsinooman ennuste on edelleen huono. Biomerkkiaineita ruokatorvisyövän ennusteen ja Barrettin ruokatorven muuntumisriskin selventämiseksi on etsitty pitkään, mutta käyttökelpoisia merkkiaineita ei ole juurikaan kliinisessä käytössä. Ei-ampullaarisen pohjukaissuolen adenoomat ja adenokarsinooma ovat sen sijaan hyvin harvinaisia kasvaimia. Tämän vuoksi niiden molekyylipatologisten ennustetekijöiden ja biomerkkiaineiden määritystyö on vielä epätäydellistä verrattuna yleisempiin syöpätyyppeihin. Hiilihappoanhydraasit (CA) ovat korkean aktiviteetin entsyymejä, jotka kontrolloivat pH:n muutoksia elimistössä. Ne osallistuvat lukuisiin kehon fysiologisiin prosesseihin, mutta niiden pääasiallinen tehtävä on säilyttää optimaaliset pH-olosuhteet soluissa ja niiden ulkopuolella. Syöpäsoluissa CAII, IX ja XII kuitenkin näyttävät olevan osallisina nk. pahanlaatuisen pH-gradientin syntymisessä. Tässä suhteessa niiden liiallinen tai liian vähäinen toiminta vaikuttaa olevan hyödyllistä syöpäsoluille. Tämän tutkimuksen tavoitteena oli selvittää CAII, IX ja XII:n immunohistokemiallinen ilmentyminen ja potentiaalinen merkitys ruokatorven ja pohjukaissuolen syövissä sekä niille altistavissa muutoksissa. Hiilihappoanhydraasien ilmentyminen määritettiin normaalissa ruokatorves
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- 2021
38. Perioperative changes in hemoglobin levels during major hepatopancreatic surgery in transfused and non-transfused patients
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Lammi, J. P. (J. P.), Eskelinen, M. (Matti), Tuimala, J. (Jarno), Selander, T. (Tuomas), Saarnio, J. (Juha), Rantanen, T. (Tuomo), Lammi, J. P. (J. P.), Eskelinen, M. (Matti), Tuimala, J. (Jarno), Selander, T. (Tuomas), Saarnio, J. (Juha), and Rantanen, T. (Tuomo)
- Abstract
Background: Several studies have shown that restrictive transfusion policies are safe. However, in clinical practice, transfusion policies seem to be inappropriate. In order to assist in decision-making concerning red blood cell transfusions, we determined perioperative hemoglobin (Hb) levels during major pancreatic and hepatic operations. Methods: Patients who underwent major pancreatic or hepatic resections between 2002 and 2011 were classified into the transfused (TF+) and non-transfused (TF) groups. The perioperative Hb values of these patients were evaluated at six points in time. Results: The study included 1596 patients, of which 785 underwent pancreatoduodenectomy, 79 total pancreatectomy, and 732 partial hepatectomy. Similar perioperative changes in Hb levels were seen in all patients regardless of whether they received a blood transfusion. In patients undergoing pancreatoduodenectomy and total pancreatectomy, the median of the lowest measured hemoglobin values was 89.2 g/L and in partial hepatectomy patients 92.6 g/L, and these were assumed to be the trigger points for red blood cell transfusion. Conclusions: Despite guidelines on blood transfusion thresholds, restrictive blood transfusion policies were not observed during our study period. After major pancreatic and hepatic surgery, Hb levels recovered without transfusions. This should encourage clinicians to obey the restrictive blood transfusion policies after major hepatopancreatic surgery.
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- 2021
39. Thirty years of esophageal cancer surgery in Oulu University Hospital
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Saviaro, H. (Henna), Rintala, J. (Jukka), Kauppila, J. H. (Joonas H.), Yannopoulos, F. (Fredrik), Meriläinen, S. (Sanna), Koivukangas, V. (Vesa), Huhta, H. (Heikki), Helminen, O. (Olli), Saarnio, J. (Juha), Saviaro, H. (Henna), Rintala, J. (Jukka), Kauppila, J. H. (Joonas H.), Yannopoulos, F. (Fredrik), Meriläinen, S. (Sanna), Koivukangas, V. (Vesa), Huhta, H. (Heikki), Helminen, O. (Olli), and Saarnio, J. (Juha)
- Abstract
Background: Esophagectomy is the mainstay of surgical treatment of esophageal cancer, but involves high operative risk. The aim of this study was to review the evolution surgical treatment of esophageal cancer in Northern Finland, with introduction of minimally invasive techniques. Methods: All elective esophagectomies performed in Oulu University Hospital between years 1987 and 2020 were included. Treatment strategies were compared to current guidelines including staging and use of neoadjuvant therapy, and benchmark values including postoperative morbidity, hospital stay, readmissions and 90-day mortality. Long-term survival was compared to previous national studies. Results: Between years 1987 and 2020 a total of 341 underwent an esophagectomy. Transhiatal resection was performed to 167 (49.3%), Ivor Lewis to 129 (38.1%) and McKeown to 42 (12.4%) patients. MIE was performed to 49 (14.5%) patients. During the past four years 83.7% of locally advanced diseases received neoadjuvant treatment. Since 1987, gradual improvements have occurred especially in incidence of pleural effusion requiring additional drainage procedure (highest in 2011–2013 and in last four years 14.0%), recurrent nerve injuries (highest in 2008–2010 29.4% and lowest in 2017–2020 1.8%) and in 1-year survival rate (1987–1998 68.4% vs. 2017–2020 82.1%). No major changes in comorbidity, complication rate, anastomosis leaks, hospital stay or postoperative mortality were seen. Conclusions: Esophageal cancer surgery has gone through major changes over three decades. Current guideline-based treatment has resulted with progressive improvement in mid- and long-term survival. However, despite modern protocol, no major improvement has occurred for example in major complications, anastomosis leak rates or hospital stay.
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- 2021
40. The quality of life of gastroesophageal reflux disease patients waiting for an antireflux operation
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Heikkinen, T., Koivukangas, V., Wiik, H., Saarnio, J., Rautio, T., and Haukipuro, K.
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- 2004
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41. Maha-suolikanavan yläosan tähystystoimenpiteet
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Tyrväinen, T. (Tuula), Saarnio, J. (Juha), and Arkkila, P. (Perttu)
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Tiivistelmä Maha-suolikanavan yläosan ahtaumia, puhkeamia ja leikkaussauman pettämisiä voidaan hoitaa endoskooppisesti itsestään laajenevilla metalliverkkoproteeseilla. Puhkeamien tai leikkaussauman pettämisten uudempana hoitovaihtoehtona on endoluminaalinen alipaineimuhoitojärjestelmä. Kaikutähystystä käytetään sekä diagnostiikkaan että toimenpiteiden tekemiseen. Limakalvoon rajoittuvat muutokset voidaan valikoidusti poistaa endoskopiassa. Toimenpiteiden haasteellisuus ja komplikaatioriskit puoltavat vaativien toimenpiteiden keskittämistä. Abstract Oesophageal obstructions, perforations and leaks have been successfully treated with self-expanding metal stents (SEMS). In gastric outlet obstruction, stenting also provides efficient and fast palliation of symptoms, with low morbidity and short hospital stay. Especially for terminally ill patients, stenting is the therapy of choice. Pancreatic cancer and gastric cancer are the most common reasons for gastric outlet obstruction. Endoscopic vacuum therapy (EVT) has become a useful option to treat perforations and leaks in the upper gastrointestinal tract. A sponge is introduced transorally into the leakage cavity or oesophageal lumen and is connected via a drainage tube to a continuous negative pressure up to 125 mmHg. The sponge is replaced every 3–5 days. However, more comparative studies are needed to compare EVT and SEMS therapy. EVT has been used longer to treat low rectal anastomotic leaks. Use of endoscopic ultrasound has been extended from diagnostic use to EUS-guided therapeutic endoscopies. Many superficial mucosal dysplastic or neoplastic lesions can be treated by mucosal resection in the upper gastrointestinal tract, too. Endoscopic mucosal resection (EMR) is used for piecemeal resection of mucosal lesions, for example a nodular dysplastic lesion in Barrett’s oesophagus. Endoscopic submucosal dissection (ESD) has been developed for dissection of larger mucosal lesions to achieve en bloc resection and to obtain a single larger specimen for histologic examination. ESD is technically quite demanding and requires a longer operation time compared to EMR. For treatment of Barrett’s oesophagus (BO) with non-granular dysplasia, radiofrequency ablation is a safe and effective mucosal eradication method.
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- 2020
42. Cohort profile:a nationwide population-based retrospective assessment of oesophageal cancer in the Finnish National Esophago-Gastric Cancer Cohort (FINEGO)
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Söderström, H. K. (Henna K.), Räsänen, J. (Jari), Saarnio, J. (Juha), Toikkanen, V. (Vesa), Tyrväinen, T. (Tuula), Rantanen, T. (Tuomo), Valtola, A. (Antti), Ohtonen, P. (Pasi), Pääaho, M. (Minna), Kokkola, A. (Arto), Kallio, R. (Raija), Karttunen, T. J. (Tuomo J.), Pohjanen, V.-M. (Vesa-Matti), Ristimäki, A. (Ari), Laine, S. (Simo), Sihvo, E. (Eero), and Kauppila, J. H. (Joonas H.)
- Subjects
surgery ,gastrointestinal tumours ,oesophageal disease ,epidemiology - Abstract
Purpose: The Finnish National Esophago-Gastric Cancer Cohort (FINEGO) was established to combine the available registry data with detailed patient information to form a comprehensive, retrospective, population-based research platform of surgically treated oesophageal and gastric cancer in Finland. This cohort profile describes the 2045 surgically treated patients with oesophageal cancer included in the FINEGO cohort. Participants: Registry data were collected from the National Cancer, Patient, Education and Death Registries from 1 January 1987 to 31 December 2016. All patients over 18 years of age, who had either curative surgery, palliative surgery or salvage surgery for primary cancer in the oesophagus are included in this study. Findings to date: 2045 patients had surgery for oesophageal cancer in the selected time period. 67.2% were man, and the majority had only minor comorbidities. The proportions of adenocarcinomas and squamous cell carcinomas were 43.1% and 44.4%, respectively, and 12.5% had other or missing histology. Only about 23% of patients received neoadjuvant therapy. Oesophagectomy was the treatment of choice and most patients were treated at low-volume centres, but median annual hospital volume increased over time. Median overall survival was 23 months, 5-year survival for all patients in the cohort was 32.9% and cancer-specific survival was 36.5%. Future plans: Even though Finland only has a population of 5.5 million, surgery for oesophageal carcinoma has not been centralised and therefore previously reported results have mostly been small, single-centre cohorts. Because of FINEGO, we now have a population-based, unselected cohort of surgically treated patients, enabling research on national trends over time regarding oesophageal cancer, including patient characteristics, tumour histology, stage and neoadjuvant treatment, surgical techniques, hospital volumes and patient mortality. Data collection is ongoing, and the cohort will be expanded to include more detailed data from patient records and national biobanks.
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- 2020
43. Claudins 1, 3, 4, 5 and 7 in esophageal cancer: loss of claudin 3 and 4 expression is associated with metastatic behavior
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TAKALA, H., SAARNIO, J., WIIK, H., and SOINI, Y.
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- 2007
44. Expression of transmembrane carbonic anhydrases IX and XII in ovarian tumours
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Hynninen, P, Vaskivuo, L, Saarnio, J, Haapasalo, H, Kivelä, J, Pastoreková, S, Pastorek, J, Waheed, A, Sly, W S, Puistola, U, and Parkkila, S
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- 2006
45. Organ system dysfunction following open cholecystectomy for acute acalculous cholecystitis in critically ill patients
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LAURILA, J., LAURILA, P. A., SAARNIO, J., KOIVUKANGAS, V., SYRJÄLÄ, H., and ALA-KOKKO, T. I.
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- 2006
46. Vitamin D and metabolic health:effects on molecular pathways of adipocyte inflammation and insulin resistance
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Herzig, K. (Karl-Heinz), Järvelin, M. (Marjo-Riitta), Saarnio, J. (Juha), Mutt, S. J. (Shivaprakash Jagalur), Herzig, K. (Karl-Heinz), Järvelin, M. (Marjo-Riitta), Saarnio, J. (Juha), and Mutt, S. J. (Shivaprakash Jagalur)
- Abstract
Vitamin D is an essential micronutrient, playing a vital role in the regulation of calcium homeostasis and bone metabolism. In recent years, vitamin D has been increasingly recognized for its regulatory functions in immunomodulation, anti-inflammation, cellular proliferation and differentiation. The pandemic vitamin D deficiency has been associated with an increasing risk for several metabolic diseases. However, the effects of vitamin D deficiency and its supplementation on the underlying molecular mechanisms of these diseases are poorly understood. This thesis focuses on the effect of vitamin D on the regulation of molecular and metabolic signaling pathways involved in adipose tissue inflammation and hepatic insulin resistance. Study I examined the effect of vitamin D on the downregulation of inflammatory signaling pathways in adipose tissue. Vitamin D inhibited the translocation of the transcriptional factor NFκB as well as inhibiting the expression of inflammatory cytokines in human adipocytes differentiated from mesenchymal stromal cells (MSCs) and mature adipocytes isolated from intra-abdominal fat biopsies. In Study II, induction of vitamin D deficiency via a deficient diet impaired systemic glucose homeostasis and insulin sensitivity in lean and obese mice. Subsequent vitamin D re-supplementation restored the insulin sensitivity and ameliorated the hepatic tissue inflammation and oxidative stress in vitamin D deficient lean but not obese mice. In Study III, lower vitamin D levels were associated with a higher incidence of the metabolic syndrome in a cross-sectional cohort of older subjects living at latitude 65° North. In conclusion, vitamin D has an important role in modulating the molecular pathways involved in adipose tissue inflammation and insulin resistance in hepatic tissue. Adequate levels of vitamin D are necessary for the regulation of metabolic pathways to maintain body homeostasis. The generated data provide novel insights into, Tiivistelmä D-vitamiini on välttämätön mikroravinne, jolla on tärkeä tehtävä kalsiumin homeostaasin ja luun aineenvaihdunnan säätelyssä. Viime vuosina D-vitamiinin on todistettu osallistuvan yhä useampiin säätelytoimintoihin liittyen immuunivasteeseen, tulehduksen torjuntaan sekä solujen jakautumiseen ja erilaistumiseen. Maailmanlaajuisesti yleinen D-vitamiinin puutostila on yhdistetty useiden aineenvaihduntasairauksien kohonneeseen riskiin. D-vitamiinin puutoksen ja D-vitamiinilisän käytön vaikutusta näiden sairauksien molekyylimekanismeihin ei kuitenkaan tunneta vielä tarkemmin. Tämä opinnäytetyö keskittyy D-vitamiinin vaikutukseen rasvakudoksen tulehduksessa ja maksan insuliiniresistenssissä olevien molekyyli- ja metabolisten signalointireittien säätelyssä. Tutkimuksessa I tarkasteltiin D-vitamiinin vaikutusta rasvakudoksen tulehduksellisten signalointireittien hillitsemiseen. D-vitamiini inhiboi transkriptionaalisen tekijän NFκB:n siirtymistä ja tulehduksellisten sytokiinien ilmentymistä ihmisen mesenkymaalisista stroomasoluista (MSC) erilaistetuissa rasvasoluissa sekä sappirakkoleikkausten yhteydessä otetuista rasvanäytteistä eristetyissä kypsissä rasvasoluissa. Tutkimuksessa II havaittiin, että D-vitamiinin puutoksen aiheuttaminen puutteellisen ruokavalion avulla heikensi verenkierron glukoositasapainoa ja insuliiniherkkyyttä sekä hoikilla, että liikalihavilla hiirillä. Sitä vastoin D-vitamiini lisäravinteena palautti insuliiniherkkyyden ja lievitti maksakudoksen tulehdusta sekä oksidatiivista stressiä D-vitamiini puutteellisilla hoikilla hiirillä, mutta ei liikalihavilla hiirillä. Tutkimuksessa III selvisi, että kohortissa matalammat D-vitamiinitasot ovat yhteydessä suurempaan metabolisen oireyhtymän esiintyvyyteen iäkkäämmillä koehenkilöillä, jotka elävät pohjoisella pallonpuoliskolla (65° N). Yhteenvetona voidaan todeta, että D-vitamiinilla on tärkeä säätelevä rooli rasvakudostulehduksen ja insuliiniresistenssin molekyylireittien kontrolloinnissa
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- 2020
47. Nutritional aspects in perioperative care
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Saarnio, J. (Juha), Nuotio, M. (Maria), Helminen, H. (Heli), Saarnio, J. (Juha), Nuotio, M. (Maria), and Helminen, H. (Heli)
- Abstract
This thesis investigates the role of nutrition in perioperative care; the effects of preoperative carbohydrate loading and whether nutrition screening tests can detect malnutrition and determine the prognosis of recovery from hip fracture in older patients. In the randomized, controlled trial (RCT) overnight fasting was compared to overnight intravenous (iv) glucose and carbohydrate-rich drink (CHD) in the morning. The patients’ subjective feelings of wellbeing were elicited using a visual analogue scale (VAS). In the second RCT overnight fasting was compared to CHD in day-case cholecystectomy patients. In the observational nutrition studies status of hip fracture patients was evaluated using the Mini Nutritional Assessment (MNA) short (SF) and long version (LF), serum albumin (S-Alb) and the Nutritional Risk Screening 2002 (NRS2002). The outcomes were the length of hospitalization, readmissions, changes in mobility and living arrangements and mortality. The changes in nutritional status and its association with the comprehensive geriatric assessment (CGA) were evaluated after six months follow-up. CHD relieved thirst better than iv solution. The CHD group was less hungry than the fasting group before the operation. Day-case cholecystectomy patients did not benefit from CHD. Of the hip fracture patients 25%, 45% and 55 % had poor nutritional status at fractura time according to the NRS2002, S-Alb and MNA tests, respectively. Poor nutritional status in the MNAs predicted prolonged hospitalization, readmissions, need for more supportive living arrangements, mobility limitations and mortality. Low S-Alb predicted mortality. The NRS2002 predicted the outcomes poorly. There was a clear deterioration in nutritional status during follow-up. Many factors in the CGA were associated with poor nutrition status: depressed mood, cognitive impairment, weakened grip strength, difficulties in activities of daily living. CHD is safe and may promote wellbeing while waiting f, Tiivistelmä Väitöskirjassa tarkastellaan ravitsemusnäkökulmia liittyen leikkaushoitoon. Kahdessa satunnaistetussa, kontrolloidussa tutkimuksessa (RCT) verrattiin hiilihydraattitankkausta paastoamiseen ennen suunniteltua leikkausta. Toisena aiheena tutkittiin ravitsemusseulontatestien toimivuuttaa tunnistaa vanhuksen vajaaravitsemus ja ennustaa toipumista lonkkamurtumasta. Verrattiin suonensisäisen (iv), juomalla annetun hiilihydraattitankkauksen (CHD) ja paaston vaikutusta vointiin leikkausta odottaessa. Vointia arvioitiin Visual Analogue Scale (VAS) mittarilla. Toisessa osatyössä verrattiin paaston ja CHD vaikutusta päiväkirurgisilla sappileikkauspotilailla. Lonkkamurtumapotilaiden ravitsemustilaa arvioitiin neljällä testillä: Mini Nutritional Assessment (MNA) lyhyt (SF) ja pitkä versio (LF), seerumin albumiini (S-Alb) ja Nutritional Risk Screening 2002 (NRS2002). Toipumismittareina käytettiin sairaalahoidon pituutta, uusia hoitojaksoja, liikuntakyvyn, asumismuodon muutosta ja kuolleisuutta. Lisäksi selvitettiin ravitsemustilan muutosta ja yhteyttä laajan geriatrisen arvioinnin (CGA) tuloksiin puoli vuotta murtumasta. CHD lievensi janoa paremmin kuin iv-liuos. CHD:tä saaneet olivat ennen leikkausta vähemmän nälkäisiä kuin paastonneet. Päiväkirurgiset potilaat eivät hyötyneet CHD:stä. Ravitsemusseulontatutkimuksissa oli murtumahetkellä potilaista vajaaravitsemusriskissä tai vajaaravittuja 25 % NRS2002-testillä, 45 % S-Alb:lla ja 55 % MNA-testeillä arvioituna. Heikentynyt ravitsemustila MNA-testien perusteella ennusti sairaalahoidon pitkittymistä, uusia hoitojaksoja, tuetumman asumismuodon tarvetta, liikuntakyvyn heikkenemistä ja kuolleisuutta. Matala S-Alb ennusti kuolleisuutta. NRS2002 ennusti huonosti toipumistuloksia. Ravitsemustila huononi useilla seuranta-aikana ja oli yhteydessä masennukseen, muistisairauteen, heikkoon käden puristusvoimaan ja heikentyneisiin tuloksiin toimintakykytesteissä CGA:ssa. CHD leikkauspäivän aamuna on turvallinen ja voi vähentää epäm
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- 2020
48. Tumour budding and tumour–stroma ratio in hepatocellular carcinoma
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Kairaluoma, V. (Valtteri), Kemi, N. (Niko), Pohjanen, V.-M. (Vesa-Matti), Saarnio, J. (Juha), Helminen, O. (Olli), Kairaluoma, V. (Valtteri), Kemi, N. (Niko), Pohjanen, V.-M. (Vesa-Matti), Saarnio, J. (Juha), and Helminen, O. (Olli)
- Abstract
Background: Tumour budding and low tumour–stroma ratio (TSR) are associated with poor prognosis in some cancers, but their value in Western hepatocellular carcinoma is unclear. The prognostic value of tumour budding and TSR in hepatocellular carcinoma was examined. Methods: Some 259 hepatocellular carcinoma patients treated in Oulu University Hospital 1983–2018 were included in this retrospective cohort study. Tumour budding and TSR were analysed from the haematoxylin- and eosin-stained original diagnostic slides, by dividing patients into bud-negative (0 bud) or bud-positive (≥1 bud) groups, and into high TSR (<50%) and low TSR (≥50%) groups. Surgically treated patients (n = 47) and other treatments (n = 212) were analysed separately. Primary outcomes were overall, and disease-specific 5-year mortality was adjusted for confounding factors. Results: Surgically treated patients with positive tumour budding had increased 5-year overall (adjusted HR 3.87, 95% CI 1.10–13.61) and disease-specific (adjusted HR 6.17, 95% CI 1.19–31.90) mortality compared with bud-negative patients. In surgically treated patients, TSR had no effect on 5-year overall (adjusted HR 2.03, 95% CI 0.57–7.21) or disease-specific (adjusted HR 3.23, 95% CI 0.78–13.37) mortality. No difference in survival related to tumour budding and TSR in non-surgically treated patients was observed. Conclusions: Tumour budding is a prognostic factor in surgically treated hepatocellular carcinoma.
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- 2020
49. Cohort profile: gastric cancer in the population-based, Finnish National Esophago-Gastric Cancer Cohort (FINEGO) Study
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Kauppila, J. H. (Joonas H.), Ohtonen, P. (Pasi), Rantanen, T. (Tuomo), Tyrväinen, T. (Tuula), Toikkanen, V. (Vesa), Pääaho, M. (Minna), Valtola, A. (Antti), Räsänen, J. (Jari), Kallio, R. (Raija), Sihvo, E. (Eero), Saarnio, J. (Juha), Karttunen, T. J. (Tuomo J.), Pohjanen, V.-M. (Vesa-Matti), Ristimäki, A. (Ari), Laine, S. (Simo), Kokkola, A. (Arto), Kauppila, J. H. (Joonas H.), Ohtonen, P. (Pasi), Rantanen, T. (Tuomo), Tyrväinen, T. (Tuula), Toikkanen, V. (Vesa), Pääaho, M. (Minna), Valtola, A. (Antti), Räsänen, J. (Jari), Kallio, R. (Raija), Sihvo, E. (Eero), Saarnio, J. (Juha), Karttunen, T. J. (Tuomo J.), Pohjanen, V.-M. (Vesa-Matti), Ristimäki, A. (Ari), Laine, S. (Simo), and Kokkola, A. (Arto)
- Abstract
Purpose: The Finnish National Esophago-Gastric Cancer Cohort (FINEGO) was established with the aim of identifying factors that could contribute to improved outcomes in oesophago-gastric cancer. The aim of this study is to describe the patients with gastric cancer included in FINEGO. Participants: A total of 10 457 patients with gastric cancer or tumour diagnosis in the Finnish Cancer Registry or the Finnish Patient Registry during 1987–2016 were included in the cohort, with follow-up from Causes of Death Registry until 31 December 2016. All of the participants were at least 18 years of age, and had undergone either resectional or endoscopic mucosal surgery with curative or palliative intent. Findings: to date Of the 10 457 patients, 90.1% were identified to have cancer in both cancer and patient registries. In all, the median age was 70 at the time of surgery, 54.5% of the patients were men and 64.4% had no comorbidities. Education data were available for 31.1% of the patients, of whom the majority had had <12 years of formal education. Of the 7798 with cancer staging data available, 41.1% had a local cancer. Adenocarcinoma was the most common (94.2%) histological type. Almost all patients underwent open gastrectomy and 214% in hospitals with annual volume of more than 30 gastrectomies per year. A total of 8561 deaths occurred during the study period, of which 6474 were due to oesophago-gastric cancers. The 5-year survival was 34.6% and 5-year cancer-specific survival was 39.7%. Future plans: The data in FINEGO can be currently used for registry-based research but is being expanded by data extraction from patient records and scanning of histological samples from the Finnish biobanks. Initially, we are planning on studies on the national trends in treatment and mortality, and studies on the demographic factors and their influence on survival.
- Published
- 2020
50. Histopathology of acute acalculous cholecystitis in critically ill patients
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Laurila, J J, Ala-Kokko, T I, Laurila, P A, Saarnio, J, Koivukangas, V, Syrjälä, H, and Karttunen, T J
- Published
- 2005
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