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Short-term Outcomes of Different Techniques for Gastric Ischemic Pre-Conditioning Before Esophagectomy: A Network Meta-Analysis by Alberto Aiolfi; Davide Bona; Gianluca Bonitta; Luigi Bonavina; Luigi Cayre; Guglielmo Guerrazzi; Christian A. Gutschow; John Lipham; Michele Manara; Călin Popa; Emanuele Rausa; Diana Schlanger; Sebastian Schoppmann; Aleksandar Simić; Andrea Sozzi; Joerg Zehetner; Gastric Ischemic Conditioning (GIC) International Collaborative Group, is a Medicine article available to read on EtoBox.

What is Short-term Outcomes of Different Techniques for Gastric Ischemic Pre-Conditioning Before Esophagectomy: A Network Meta-Analysis about?

## Background: Ischemia at the anastomotic site is a critical protagonist in the development of anastomosis-related complications after esophagectomy. Gastric ischemic conditioning (GIC) before esophagectomy has been described to improve the vascular perfusion at the tip of the gastric conduit with a potential effect on anastomotic leak (AL) and stenosis (AS) risk minimization. Laparoscopic (LapGIC) and angioembolization (AngioGIC) techniques have been reported. ## Purpose: Compare short-term outcomes among different GIC techniques. ## Methods: Systematic review and network meta-analysis. One-step esophagectomy (noGIC), LapGIC, and AngioGIC were compared. Primary outcomes were AL, AS, and gastric conduit necrosis (GCN). Risk ratio (RR) and weighted mean difference (WMD) were used as pooled effect size measures, whereas 95% credible intervals (CrI) were used to assess relative inference. ## Results: Overall, 1760 patients (14 studies) were included. Of those, 1028 patients (58.4%) underwent noGIC, 593 (33.6%) LapGIC, and 139 (8%) AngioGIC. AL was reduced for LapGIC vs. noGIC (RR=0.68; 95% CrI 0.47-0.98) and AngioGIC vs. noGIC (RR=0.52; 95% CrI 0.31-0.93). Similarly, AS was reduced f

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Author

Alberto Aiolfi; Davide Bona; Gianluca Bonitta; Luigi Bonavina; Luigi Cayre; Guglielmo Guerrazzi; Christian A. Gutschow; John Lipham; Michele Manara; Călin Popa; Emanuele Rausa; Diana Schlanger; Sebastian Schoppmann; Aleksandar Simić; Andrea Sozzi; Joerg Zehetner; Gastric Ischemic Conditioning (GIC) International Collaborative Group,

Publisher

Ovid Technologies (Wolters Kluwer Health)

Published

2023

Field

Medicine (Health Sciences)