| Title |
Calcification score versus arterial stenosis grading: comparison of two CT-based methods for risk assessment of anastomotic leakage after esophagectomy and gastric pull-up
|
|---|---|
| Published in |
Therapeutics and Clinical Risk Management, April 2018
|
| DOI | 10.2147/tcrm.s157352 |
| Pubmed ID | |
| Authors |
De-Hua Chang, Sebastian Brinkmann, Lucy Smith, Ingrid Becker, Wolfgang Schroeder, Arnulf H Hoelscher, Stefan Haneder, David Maintz, Judith Eva Spiro |
| Abstract |
Anastomotic leakage is a major surgical complication following esophagectomy and gastric pull-up. Specific risk factors such as celiac trunk (TC) stenosis and high calcification score of the aorta have been identified, but no data are available on their relative prognostic values. This retrospective study aimed to compare and evaluate calcification score versus stenosis quantification with regards to prognostic impact on anastomotic leakage. Preoperative contrast-enhanced computed tomography scans of 164 consecutive patients with primary esophageal cancer were evaluated by two radiologists to apply a calcification score (0-3 scale) assessing the aorta, the celiac axis and the right and left postceliac arteries. Concurrently, the presence and degree of stenosis of TC and superior mesenteric artery were recorded for stenosis quantification. Anastomotic leakage was noted in 14/164 patients and 12/14 showed stenosis of TC (n=11). The presence of TC stenosis was found to have a significant impact on anastomotic healing (p=0.004). The odds ratio for the prediction of anastomotic leakage by the degree of stenosis was 1.04 (95% CI, 1.02-1.07). Ten of 14 patients had aortic calcification scores of 1 or 2, but calcification scores of the aorta, the celiac axis and the right and left postceliac arteries did not correlate with the corresponding TC stenosis values and showed no influence on patient outcome as defined by the occurrence of anastomotic insufficiency (p=0.565, 0.855, 0.518 and 1.000, respectively). Inter-reader reliability of computed tomography analysis and absolute agreement on calcium scoring was mostly over 90%. No significant differences in preoperative comorbidities and patient characteristics were found between those with and without anastomotic leakage. Measurement of TC stenosis in preoperative contrast-enhanced computed tomography scans proved to be more reliable than calcification scores in predicting anastomotic leakage and should, therefore, be used in the risk assessment of patients undergoing esophagectomy and gastric pull-up. |
X Demographics
The data shown below were collected from the profiles of 4 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 2 | 50% |
| Unknown | 2 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 2 | 50% |
| Members of the public | 2 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 32 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 32 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 5 | 16% |
| Student > Ph. D. Student | 3 | 9% |
| Student > Postgraduate | 2 | 6% |
| Professor > Associate Professor | 2 | 6% |
| Student > Doctoral Student | 1 | 3% |
| Other | 4 | 13% |
| Unknown | 15 | 47% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 13 | 41% |
| Engineering | 3 | 9% |
| Psychology | 1 | 3% |
| Nursing and Health Professions | 1 | 3% |
| Chemistry | 1 | 3% |
| Other | 1 | 3% |
| Unknown | 12 | 38% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 May 2018.
All research outputs
#14,789,745
of 25,382,440 outputs
Outputs from Therapeutics and Clinical Risk Management
#629
of 1,323 outputs
Outputs of similar age
#174,895
of 343,807 outputs
Outputs of similar age from Therapeutics and Clinical Risk Management
#14
of 35 outputs
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We're also able to compare this research output to 35 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 60% of its contemporaries.