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| 1 | Incidence and treatment of mediastinal leakage after esophagectomy:Insights from the multicenter study on mediastinal leaks显示文摘BACKGROUND Mediastinal leakage(ML) is one of the most feared complications of esophagectomy. A standard strategy for its diagnosis and treatment has beendifficult to establish because of the great variability in their incidence and mortality rates reported in the existing series.AIM To assess the incidence, predictive factors, treatment, and associated mortality rate of mediastinal leakage using the standardized definition of mediastinal leaks recently proposed by the Esophagectomy Complications Consensus Group(ECCG).METHODS Seven Italian surgical centers(five high-volume, two low-volume) affiliated with the Italian Society for the Study of Esophageal Diseases designed and implemented a retrospective study including all esophagectomies(n = 501) with intrathoracic esophagogastric anastomosis performed from 2014 to 2017.Anastomotic MLs were defined according to the classification recently proposed by the ECCG.RESULTS Fifty-nine cases of ML were recorded, yielding an overall incidence of 11.8%(95%CI: 9.1%-14.9%). The surgical approach significantly influenced the occurrence of ML: the proportion of leakage was 10.5% and 9% after open and hybrid esophagectomy(HE), respectively, and doubled(20%) after totally minimally invasive esophagectomy(TMIE)(P = 0.016). No other predictive factors were found. The 30-and 90-d overall mortality rates were 1.4% and 3.2%,respectively; the 30-and 90-d leak-related mortality rates were 5.1% and 10.2%,respectively; the 90-d mortality rates for TMIE and HE were 5.9% and 1.8%,respectively. Endoscopy was the first-line treatment in 49% of ML cases, with the need for retreatment in 17.2% of cases. Surgery was needed in 44.1% of ML cases.Endoscopic treatment had the lowest mortality rate(6.9%). Removal of the gastric tube with stoma formation was necessary in 8(13.6%) cases.CONCLUSION The incidence of ML after esophagectomy was high mainly in the TMIE group.However, the general and specific(leak-related) mortality rates were low. Early treatment(surgical or endoscopic) of severe leaks is mandatory to limit related mortality. | Uberto Fumagalli Gian Luca Baiocchi ANDrea Celotti Paolo Parise ANDrea Cossu Luigi Bonavina Daniele Bernardi Giovanni de Manzoni Jacopo Weindelmayer Giuseppe Verlato Stefano Santi Giovanni Pallabazzer Nazario Portolani Maurizio Degiuli Rossella Reddavid Stefano de Pascale | 2019 | World Journal of Gastroenterology2019，25，3： | 3 |
| 2 | Porosity-graded hydroxyapatite ceramics made of natural bone显示文摘 | TAMPIERI A CELOTTI G SPRIO S | 2001 | Biomaterials2001，22，11： | 1 |
| 3 | Resveratrol content of some wines obtained from dried Valpolicella grapes:recioto and amarone显示文摘 | Celotti E Ferrarini R Zironi R | 1996 | J Chromatogr A1996，730，12： | 1 |
| 4 | A novel sol-gel tec hnique for hydroxyapatite preparation 显示文摘 | Bezzi G Celotti G Landi E | 2003 | Materials Chemistry and Physical2003，78，： | 1 |
| 5 | Influence of Synthesis and Sintering Parameters on the Characteristics of Carbonate Apatite显示文摘 | Landi E Tampieri A Celotti G | | 0，，10： | 1 |
| 6 | Magnesium doped hydroxyapatite: synthesis and characterization 显示文摘 | TAMPIERI A CELOTTI G LANDI E | 2004 | Key Engineering Materials2004，，： | 1 |
| 7 | Effects of copper doping in MgB2 superconductor显示文摘 | TANMPIERI A CELOTTI G SPRIO S BARUCCA D | 2002 | Solid State Communications2002，121，： | 1 |
| 8 | Densification behaviour and mechanisms of synthetic hydroxyapatites 显示文摘 | Landi E Tampieri A Celotti G | 2000 | Journal of the European Ceramic Society2000，20，1415： | 1 |
| 9 | 显示文摘 | Tampieri A Celotti G Sprio S | 2001 | Biomaterials2001，22，： | 1 |
| 10 | Silicon nitride-nickel joints through diffusion bonding显示文摘 | Esposito L Bellosi A Celotti G | 1997 | Acta Materialia1997，45，12： | 1 |
| 11 | Carbonated hydro-xyapatite as bone substitute显示文摘 | Landi E Celotti G Logroscino G | 2003 | Journal of the European Ceramic Society2003，23，15： | 1 |
| 12 | Nucleation of biomimetic apatite in synthetic body fluids: dense and porous scaffold development显示文摘 | Elena Landi Anna Tampieri Giancarlo Celotti Ratih Langenati Monica Sandri Simone Sprio | 2004 | Biomaterials2004，，16： | 1 |
| 13 | Sintering and Characterization of HA and TCP Bioceramics with Control of their Strength and Phase Purity显示文摘 | Celotti G Szontangh F | 1997 | Journal of Materials Science: Materials in Medicine1997，8，8： | 1 |
| 14 | Effect of plateletrich plasma on migration and proliferation of SaOS-2 osteoblasts:role of platelet-derived growth factor and transforming growth factor-beta显示文摘 | Celotti F Colciago A Negri-Cesi P | | 0，，02： | 1 |
| 15 | Influence of synthesis and sintering parameters on the characteristics of carbonate apatite显示文摘 | Elena Landi Anna Tampieri Giancarlo Celotti Lucia Vichi Monica Sandri | 2003 | Biomaterials2003，，10： | 1 |
| 16 | A jet model for the gamma-ray emitting blazer 3C279显示文摘 | MARSCHI L GHISELLINI G CELOTTI A | 1992 | ApJ1992，，397： | 1 |
| 17 | Carbonated hydroxyapatite as bone substitute显示文摘 | Landi E Celotti G Logroscino G | 2003 | Journal of the European Ceramics Society2003，23，15： | 1 |
| 18 | Effect of platelet-rich plasma on migration and proliferation of SaOS-2 osteoblasts: role of platelet-derived growth factor and transforming growth factor- beta显示文摘 | Celotti F Colciago A Negri-Cesi P | 2006 | Wound Repair Regen2006，14，： | 1 |
| 19 | Antiradical properties of commercial cognacs assessed by the DPPH test显示文摘 | Da Porto C Calligaris S Celotti E | 2000 | J Agric Food Chem2000，48，： | 1 |
| 20 | Gastric cancer: extent of lymph node dissection and requirements for a correct staging显示文摘 | Cozzaglio L Doci R Celotti S | 2004 | Tumori2004，90，5： | 1 |
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