Role of Radiology in the Preoperative Detection of Arterial Calcification and Celiac Trunk Stenosis and Its Association with Anastomotic Leakage Post Esophagectomy, an Up-to-Date Review of the Literature

Surgical resection of the esophagus remains a critical component of the multimodal treatment of esophageal cancer. Anastomotic leakage (AL) is the most significant complication following esophagectomy, in terms of clinical implications. Identifying risk factors for AL is important for modifying pati...

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Published inCancers Vol. 14; no. 4; p. 1016
Main Authors Tzortzakakis, Antonios, Kalarakis, Georgios, Huang, Biying, Terezaki, Eleni, Koltsakis, Emmanouil, Kechagias, Aristotelis, Tsekrekos, Andrianos, Rouvelas, Ioannis
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 17.02.2022
MDPI
Subjects
Abdomen
Anastomotic leak
Aorta
arterial calcification
Arteries
Arteriosclerosis
Calcification
Calcification (ectopic)
Cancer therapies
Computed tomography
Coronary vessels
Endoscopy
Esophageal cancer
esophagectomy
Esophagus
Literature reviews
Medical imaging
Medicin och hälsovetenskap
Mortality
Patients
Plaques
Quality of life
Radiology
Risk factors
Stenosis
Systematic Review
Veins & arteries
computed tomography
risk factors
esophageal cancer
anastomotic leak
arterial calcification
esophagectomy
celiac trunk stenosis
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Abstract Surgical resection of the esophagus remains a critical component of the multimodal treatment of esophageal cancer. Anastomotic leakage (AL) is the most significant complication following esophagectomy, in terms of clinical implications. Identifying risk factors for AL is important for modifying patient management and improving surgical outcomes. This review aims to examine the role of radiological risk factors for AL after esophagectomy, and in particular, arterial calcification and celiac trunk stenosis. Eligible publications prior to 25 August 2021 were retrieved from Medline and Google Scholar using a predefined search algorithm. A total of 68 publications were identified, of which 9 original studies remained for in-depth analysis. The majority of these studies found correlations between calcifications in the aorta, celiac trunk, and right post-celiac arteries and AL following esophagectomy. Some studies suggest celiac trunk stenosis as a more appropriate surrogate. Our up-to-date review highlights the need for automated quantification of aortic calcifications, as well as the degree of celiac trunk stenosis in preoperative computed tomography in patients undergoing esophagectomy, to obtain robust and reproducible measurements that can be used for a definite correlation.
AbstractList Simple SummaryEsophageal cancer is the sixth deadliest among all cancers worldwide. Multimodal treatment, including surgical resection of the esophagus, offers the potential for cure even in advanced cases, but esophagectomy is still associated with serious complications. Among these, anastomotic leakage has the most significant clinical impact, both in terms of prognosis and health-related quality of life. Identifying patients at a high risk for leakage is of great importance in order to modify their treatment and, if possible, avoid this complication. This review aims to study the current literature regarding the role of radiology in detecting potential risk factors associated with anastomotic leakage. The measurement of calcium plaques on the aorta, as well as the detection of narrowing of the celiac trunk and its branches, can be easily assessed by preoperative computed tomography, and can be used to individualize perioperative patient management to effectively reduce the rate of leakage.AbstractSurgical resection of the esophagus remains a critical component of the multimodal treatment of esophageal cancer. Anastomotic leakage (AL) is the most significant complication following esophagectomy, in terms of clinical implications. Identifying risk factors for AL is important for modifying patient management and improving surgical outcomes. This review aims to examine the role of radiological risk factors for AL after esophagectomy, and in particular, arterial calcification and celiac trunk stenosis. Eligible publications prior to 25 August 2021 were retrieved from Medline and Google Scholar using a predefined search algorithm. A total of 68 publications were identified, of which 9 original studies remained for in-depth analysis. The majority of these studies found correlations between calcifications in the aorta, celiac trunk, and right post-celiac arteries and AL following esophagectomy. Some studies suggest celiac trunk stenosis as a more appropriate surrogate. Our up-to-date review highlights the need for automated quantification of aortic calcifications, as well as the degree of celiac trunk stenosis in preoperative computed tomography in patients undergoing esophagectomy, to obtain robust and reproducible measurements that can be used for a definite correlation.
Surgical resection of the esophagus remains a critical component of the multimodal treatment of esophageal cancer. Anastomotic leakage (AL) is the most significant complication following esophagectomy, in terms of clinical implications. Identifying risk factors for AL is important for modifying patient management and improving surgical outcomes. This review aims to examine the role of radiological risk factors for AL after esophagectomy, and in particular, arterial calcification and celiac trunk stenosis. Eligible publications prior to 25 August 2021 were retrieved from Medline and Google Scholar using a predefined search algorithm. A total of 68 publications were identified, of which 9 original studies remained for in-depth analysis. The majority of these studies found correlations between calcifications in the aorta, celiac trunk, and right post-celiac arteries and AL following esophagectomy. Some studies suggest celiac trunk stenosis as a more appropriate surrogate. Our up-to-date review highlights the need for automated quantification of aortic calcifications, as well as the degree of celiac trunk stenosis in preoperative computed tomography in patients undergoing esophagectomy, to obtain robust and reproducible measurements that can be used for a definite correlation.
Author Tzortzakakis, Antonios
Kalarakis, Georgios
Huang, Biying
Kechagias, Aristotelis
Tsekrekos, Andrianos
Koltsakis, Emmanouil
Terezaki, Eleni
Rouvelas, Ioannis
AuthorAffiliation 1 Department of Clinical Science, Division of Radiology, Intervention and Technology (CLINTEC), Karolinska Institutet, 141 86 Stockholm, Sweden; antonios.tzortzakakis@ki.se (A.T.); georgios.kalarakis@ki.se (G.K.)
3 Department of Radiology, Karolinska University Hospital, Huddinge, 141 86 Stockholm, Sweden
9 Department of Clinical Science, Division of Surgery, Intervention and Technology (CLINTEC), Karolinska Institutet, 141 86 Stockholm, Sweden
6 Department of Emergency Medicine, Karolinska University Hospital, 171 64 Stockholm, Sweden; terezakielena@gmail.com
5 Department of General Surgery, Södertälje Hospital, 152 86 Södertälje, Sweden
7 Department of Radiology, Karolinska University Hospital, Solna, 171 64 Stockholm, Sweden; emmanouilkolts@gmail.com
2 Medical Radiation Physics and Nuclear Medicine, Functional Unit of Nuclear Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden
4 Department of Upper Abdominal Surgery, Karolinska University Hospital Huddinge, 141 86 Stockholm,
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– name: 2 Medical Radiation Physics and Nuclear Medicine, Functional Unit of Nuclear Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden
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Keywords computed tomography
risk factors
esophageal cancer
anastomotic leak
arterial calcification
esophagectomy
celiac trunk stenosis
Language English
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Snippet Surgical resection of the esophagus remains a critical component of the multimodal treatment of esophageal cancer. Anastomotic leakage (AL) is the most...
Simple SummaryEsophageal cancer is the sixth deadliest among all cancers worldwide. Multimodal treatment, including surgical resection of the esophagus, offers...
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StartPage 1016
SubjectTerms Abdomen
Anastomotic leak
Aorta
arterial calcification
Arteries
Arteriosclerosis
Calcification
Calcification (ectopic)
Cancer therapies
Computed tomography
Coronary vessels
Endoscopy
Esophageal cancer
esophagectomy
Esophagus
Literature reviews
Medical imaging
Medicin och hälsovetenskap
Mortality
Patients
Plaques
Quality of life
Radiology
Risk factors
Stenosis
Systematic Review
Veins & arteries
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Title Role of Radiology in the Preoperative Detection of Arterial Calcification and Celiac Trunk Stenosis and Its Association with Anastomotic Leakage Post Esophagectomy, an Up-to-Date Review of the Literature
URI https://www.ncbi.nlm.nih.gov/pubmed/35205764
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