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Marlene Malmström, Bodil Ivarsson, Rosemarie Klefsgård, Kerstin Persson, Ulf Jakobsson, Jan Johansson
BACKGROUND: Following oesophagectomy, a major surgical procedure, it is known that patients suffer from severely reduced quality of life and have an unmet need for postoperative support. Still, there is a lack of research testing interventions aiming to enhance the patients' life situation after this surgical procedure. AIM: The aim of the study was to evaluate the effect of a nurse led telephone supportive care programme on quality of life (QOL), received information and the number of healthcare contacts compared to conventional care following oesophageal resection for cancer...
September 13, 2016: International Journal of Nursing Studies
Seo-In Ha, Kyunghee Kim, Ji-Su Kim
PURPOSE: After oesophagectomy, anatomical changes and loss of function induce various symptoms that may affect quality of life (QoL) in oesophageal cancer patients. The purpose of this study was to identify the factors influencing QoL in Korean patients who have undergone oesophageal cancer surgery. METHOD: This was a cross-sectional study of a convenience sample consisting of 120 surgery patients with oesophageal cancer. We used the EORTC QLQ-C30 and EORTC QLQ-OES18 to measure participants' oesophageal cancer-related symptoms and QoL...
October 2016: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
S M Lagarde, M Navidi, S S Gisbertz, H W M van Laarhoven, K Sumpter, S L Meijer, B Disep, A Immanuel, S M Griffin, M I van Berge Henegouwen
BACKGROUND: The significance of extracapsular lymph node involvement (LNI) is unclear in patients with oesophageal cancer who have undergone neoadjuvant treatment followed by oesophagectomy. The aim of this study was to assess the incidence and prognostic significance of extracapsular LNI in a large multicentre series of consecutive patients with oesophageal cancer treated by neoadjuvant chemotherapy or chemoradiotherapy and surgery. METHODS: Data from a consecutive series of patients treated at two European centres were analysed...
October 3, 2016: British Journal of Surgery
F Klevebro, M Lindblad, J Johansson, L Lundell, M Nilsson
BACKGROUND: Randomized trials have shown that neoadjuvant treatment improves survival in the curative treatment of oesophageal and gastro-oesophageal junction cancer. Results from population-based observational studies are, however, sparse and ambiguous. METHODS: This prospective population-based cohort study included all patients who had oesophagectomy for cancer in Sweden, excluding clinical T1 N0, recorded in the National Register for Oesophageal and Gastric Cancer, 2006-2014...
September 30, 2016: British Journal of Surgery
T Nishigori, H Miyata, H Okabe, Y Toh, H Matsubara, H Konno, Y Seto, Y Sakai
BACKGROUND: Previous studies have reported that patients undergoing oesophagectomy in high-volume hospitals experience lower mortality rates. However, there has been ongoing discussion regarding the validity of evidence for this association. The purpose of this study was to investigate the relationship between hospital volume and risk-adjusted mortality following oesophagectomy in Japan, using a nationwide web-based database. METHODS: The study included patients registered in the database as having undergone oesophagectomy with reconstruction between 2011 and 2013...
September 29, 2016: British Journal of Surgery
Eitan Podgaetz, Rafael Garza-Castillon, Rafael S Andrade, Jose Vega-Peralta
OBJECTIVES: Benign gastro-oesophageal anastomotic strictures after oesophagectomy can occur in up to 42% of patients. Traditional management includes serial dilations. We report our initial experience with the use of a dual-anchor, lumen-apposing endoluminal stent for the management of recurrent anastomotic strictures after oesophagectomy. METHODS: Retrospective review of patients who underwent 'off label' placement of a dual-anchor stent for recurrent anastomotic strictures...
September 15, 2016: European Journal of Cardio-thoracic Surgery
Sheraz R Markar, Karl Wahlin, Fredrik Mattsson, Pernilla Lagergren, Jesper Lagergren
OBJECTIVE: Previous studies indicate an increased short-term and long-term mortality from major cancer surgery performed towards the end of the working week or during the weekend. We hypothesised that the prognosis after major cancer surgery is also negatively influenced by surgery conducted during holiday periods. SETTING: Population-based nationwide Swedish cohort study. PARTICIPANTS: Patients undergoing oesophagectomy for oesophageal cancer between 1987 and 2010...
2016: BMJ Open
Paul R Burton, Geraldine J Ooi, Kalai Shaw, Andrew I Smith, Wendy A Brown, Peter D Nottle
BACKGROUND: Outcomes of oesophago-gastric cancer are poor and highly variable between centres. It is important that complex multimodal treatments are applied optimally. Low case volumes at Australian centres mean that the analysis of crude outcomes is an inadequate assessment of overall quality of care. Detailed analysis across a range of quality domains offers the opportunity to measure performance. METHODS: We compared data from the UK National Oesophago-gastric Cancer Audit 2010 with the prospective Alfred Hospital oesophago-gastric cancer database...
September 6, 2016: ANZ Journal of Surgery
Philippe Rinieri, Moussa Ouattara, Geoffrey Brioude, Anderson Loundou, Henri de Lesquen, Delphine Trousse, Christophe Doddoli, Pascal Alexandre Thomas, Xavier Benoit D'Journo
OBJECTIVES: It has been suggested that laparoscopic Ivor Lewis (IL) oesophagectomy reduces postoperative morbidity and mortality rates. However, data related to the long-term outcomes of this hybrid minimally invasive procedure are scarce. METHODS: All of the patients who had an IL oesophagectomy for cancer were extracted from a prospective database. Patients were matched one to one according to the surgical approach (laparoscopy versus laparotomy) and on the basis of a propensity score including eight variables: age, gender, American Society of Anaesthesiologists score, forced expiratory volume in 1 s, surgery (first-line treatment, after neoadjuvant treatment and salvage surgery), histology, location and pathological stage...
September 4, 2016: European Journal of Cardio-thoracic Surgery
Y A Qureshi, S-J Sarker, R C Walker, S F Hughes
OBJECTIVE: The purpose of this study was to investigate whether a long proximal oesophageal resection margin (PRM) is associated with improved survival after oesophagectomy for cancer and to identify the optimal margin to aim for in this patient group. METHODS: A prospectively maintained database identified 174 patients who underwent Ivor-Lewis oesophagectomy for cancer. Demographic, clinical, and pathological data were collected. X-tile software was used to identify the optimal resection point...
August 29, 2016: Annals of Surgical Oncology
L Backemar, A Wikman, T Djärv, A Johar, P Lagergren
BACKGROUND: Although health-related quality of life (HRQoL) recovers after surgery for oesophageal cancer in most long-term survivors, one in seven patients experiences a deterioration in HRQoL for reasons yet unknown. The aim of this study was to assess whether co-morbidities diagnosed after surgery influence recovery of HRQoL. METHODS: Patients who underwent surgery for cancer of the oesophagus or gastro-oesophageal junction in Sweden between 2001 and 2005 were included...
August 22, 2016: British Journal of Surgery
Ruben T H M Larue, Lien Van De Voorde, Maaike Berbée, Wouter J C van Elmpt, Ludwig J Dubois, Kranthi M Panth, Sarah G J A Peeters, Ann Claessens, Wendy M J Schreurs, Marius Nap, Fabiënne A R M Warmerdam, Frans L G Erdkamp, Meindert N Sosef, Philippe Lambin
BACKGROUND: Neo-adjuvant chemoradiotherapy followed by surgery is the standard treatment with curative intent for oesophageal cancer patients, with 5-year overall survival rates up to 50 %. However, patients' quality of life is severely compromised by oesophagectomy, and eventually many patients die due to metastatic disease. Most solid tumours, including oesophageal cancer, contain hypoxic regions that are more resistant to chemoradiotherapy. The hypoxia-activated prodrug evofosfamide works as a DNA-alkylating agent under these hypoxic conditions, which directly kills hypoxic cancer cells and potentially minimizes resistance to conventional therapy...
2016: BMC Cancer
Gijs H K Berkelmans, Bas J W Wilts, Ewout A Kouwenhoven, Koshi Kumagai, Magnus Nilsson, Teus J Weijs, Grard A P Nieuwenhuijzen, Marc J van Det, Misha D P Luyer
INTRODUCTION: Early start of an oral diet is safe and beneficial in most types of gastrointestinal surgery and is a crucial part of fast track or enhanced recovery protocols. However, the feasibility and safety of oral intake directly following oesophagectomy remain unclear. The aim of this study is to investigate the effects of early versus delayed start of oral intake on postoperative recovery following oesophagectomy. METHODS AND ANALYSIS: This is an open-label multicentre randomised controlled trial...
August 5, 2016: BMJ Open
P Howells, D Thickett, C Knox, D Park, F Gao, O Tucker, T Whitehouse, D McAuley, G Perkins
BACKGROUND: The Acute Respiratory Distress Syndrome (ARDS) is a serious complication of major surgery and consumes substantial healthcare resources. Oesophagectomy is associated with high rates of ARDS. The aim of this study was to characterize patients and identify risk factors for developing ARDS after oesophagectomy. METHODS: A secondary analysis of data from 331 patients gathered during the Beta Agonists Lung Injury Prevention Trial was undertaken. Characteristics and outcomes of patients with early (first 72 h postoperatively) and late (after 72 h) ARDS were determined...
September 2016: British Journal of Anaesthesia
Yin-Kai Chao, Hui-Shan Chen, Bing-Yen Wang, Po-Kuei Hsu, Chia-Chuan Liu, Shiao-Chi Wu
OBJECTIVES: Few data are currently available on the factors associated with survival in oesophageal cancer patients who achieve pathological complete response (pCR) after chemoradiotherapy (CRT). Using a nationwide database, we investigated the predictors of survival in this patient group. METHODS: Data were retrieved from the Taiwan Cancer Registry to identify patients with oesophageal squamous cell carcinoma (OSCC) who achieved pCR after CRT followed by oesophagectomy between 2008 and 2013...
July 11, 2016: European Journal of Cardio-thoracic Surgery
M Elshaer, G Gravante, J White, J Livingstone, A Riaz, A Al-Bahrani
Introduction Oesophagectomy for cancer is a challenging procedure with a five-year overall survival rate of 15-20%. Early enteral nutrition following oesophagectomy is a crucial component of the postoperative recovery and carries a significant impact on the outcome. Different methods of enteral feeding were conducted in our unit. The aim of this study was to examine the efficacy and safety of nasojejunal tube (NJT), jejunostomy tube (JT) and pharyngostomy tube (PT) feeding after oesophagectomy. Methods A retrospective review was carried out of prospectively collected data on patients with oesophageal cancer who underwent an oesophagectomy between 2011 and 2014...
September 2016: Annals of the Royal College of Surgeons of England
Chris Metcalfe, Kerry Avery, Richard Berrisford, Paul Barham, Sian M Noble, Aida Moure Fernandez, George Hanna, Robert Goldin, Jackie Elliott, Timothy Wheatley, Grant Sanders, Andrew Hollowood, Stephen Falk, Dan Titcomb, Christopher Streets, Jenny L Donovan, Jane M Blazeby
BACKGROUND: Localised oesophageal cancer can be curatively treated with surgery (oesophagectomy) but the procedure is complex with a risk of complications, negative effects on quality of life and a recovery period of 6-9 months. Minimal-access surgery may accelerate recovery. OBJECTIVES: The ROMIO (Randomised Oesophagectomy: Minimally Invasive or Open) study aimed to establish the feasibility of, and methodology for, a definitive trial comparing minimally invasive and open surgery for oesophagectomy...
June 2016: Health Technology Assessment: HTA
Ben Oakley, Christopher Lamb, Ravinder Vohra, James Catton
AIMS: Surgical resection is often the only curative treatment for oesophageal cancer. The aim of this retrospective cohort study was to analyse outcomes following oesophageal resection in patients aged 75 years and older and the impact of an Enhanced Recovery after Surgery (ERAS) program in this cohort. METHODS: Patients aged over 75 years undergoing oesophagectomy between 2003 and 2013 were identified from a single centre using an electronic database. Data on pre-operative comorbidity, tumour stage and length of hospital stay (LOS) were collected...
August 2016: Annals of Medicine and Surgery
Sophie E Heethuis, Peter S N van Rossum, Irene M Lips, Lucas Goense, Francine E Voncken, Onne Reerink, Richard van Hillegersberg, Jelle P Ruurda, Marielle E Philippens, Marco van Vulpen, Gert J Meijer, Jan J W Lagendijk, Astrid L H M W van Lier
PURPOSE: To explore and evaluate the potential value of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) for the prediction of pathologic response to neoadjuvant chemoradiotherapy (nCRT) in oesophageal cancer. MATERIAL AND METHODS: Twenty-six patients underwent DCE-MRI before, during (week 2-3) and after nCRT, but before surgery (pre/per/post, respectively). Histopathologic tumour regression grade (TRG) was assessed after oesophagectomy. Tumour area-under-the-concentration time curve (AUC), time-to-peak (TTP) and slope were calculated...
July 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Mikael Lund, Jon A Tsai, Magnus Nilsson, Reidar Winter, Lars Lundell, Sigridur Kalman
BACKGROUND: Neoadjuvant chemoradiotherapy might improve oncological outcome compared with chemotherapy after surgery for oesophagus or gastrooesophageal junction cancer. However, radiotherapy may induce cardiovascular side-effects that could increase the risk of perioperative adverse effects and postoperative morbidity. OBJECTIVES: The aim of this study was to compare the perioperative haemodynamics in patients undergoing oesophagectomy following neoadjuvant chemotherapy or chemoradiotherapy for cancer...
September 2016: European Journal of Anaesthesiology
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