Gastric Preconditioning in Advance of Esophageal Resection-Systematic Review and Meta-Analysis View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-09

AUTHORS

Patrick Heger, Susanne Blank, Markus K. Diener, Alexis Ulrich, Thomas Schmidt, Markus W. Büchler, André L. Mihaljevic

ABSTRACT

BACKGROUND: Anastomotic leakage is one of the most severe complications following esophageal resection. Among other strategies, gastric ischemic preconditioning has been proposed to improve anastomotic integrity. The aim of this systematic review is to investigate whether gastric preconditioning has influence on peri- or postoperative outcomes after esophageal resection. METHODS: A systematic literature search was performed to identify studies comparing gastric preconditioning with non-preconditioned patients for any indication of esophageal resection. Random-effects meta-analyses were conducted for main outcomes. RESULTS: Gastric preconditioning did not reduce anastomotic leakages (OR 0.76; 95%-CI 0.51 to 1.13; p = 0.18), anastomotic strictures (OR 1.10; 95%-CI 0.58 to 2.10; p = 0.76;), major complications (OR 1.14; 95%-CI 0.60 to 2.14; p = 0.69), or in-hospital mortality (OR 0.62; 95%-CI 0.28 to 1.40; p = 0.25). However, preconditioning reduced the rate of severe leaks requiring reoperation (OR 0.20; 95%-CI 0.08 to 0.53; p = 0.001). Increasing the period between preconditioning and esophageal resection over 2 weeks did not reduce anastomotic leakage compared to shorter waiting times (OR 0.65; 95%-CI 0.38 to 1.13; p = 0.13). CONCLUSION: With current evidence, gastric preconditioning does not seem to reduce overall rates of anastomotic leakage after esophageal resection but seems to reduce severity of leakages. More... »

PAGES

1523-1532

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  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s11605-017-3416-z

    DOI

    http://dx.doi.org/10.1007/s11605-017-3416-z

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1085053524

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/28439770


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