{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T11:27:00Z","timestamp":1784028420460,"version":"3.55.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T00:00:00Z","timestamp":1683244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100008894","name":"Stryker","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008894","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Anastomotic leakage (AL) after esophagectomy is the most impactful complication after esophagectomy. Ischemic conditioning (ISCON) of the stomach &amp;gt;14\u00a0days prior to esophagectomy might reduce the incidence of AL. The current trial was conducted to prospectively investigate the safety and feasibility of laparoscopic ISCON in selected patients. This international multicenter feasibility trial included patients with esophageal cancer at high risk for AL with major calcifications of the thoracic aorta or a stenosis in the celiac trunk. Patients underwent laparoscopic ISCON by occlusion of the left gastric and the short gastric arteries followed by esophagectomy after an interval of 12\u201318\u00a0days. The primary endpoint was complications Clavien-Dindo\u2009\u2265\u2009grade 2 after ISCON and before esophagectomy. Between November 2019 and January 2022, 20 patients underwent laparoscopic ISCON followed by esophagectomy. Out of 20, 16 patients (80%) underwent neoadjuvant treatment. The median duration of the laparoscopic ISCON procedure was 45\u00a0minutes (range: 25\u2013230). None of the patients developed intraoperative or postoperative complications after ISCON. Hospital stay after ISCON was median 2\u00a0days (range: 2\u20134\u00a0days). Esophagectomy was completed in all patients after a median of 14\u00a0days (range: 12\u201328). AL occurred in three patients (15%), and gastric tube necrosis occurred in one patient (5%). In hospital, the 30-day and 90-day mortalities were 0%. Laparoscopic ISCON of the gastric conduit is feasible and safe in selected esophageal cancer patients with an impaired vascular status. Further studies have to prove whether this innovative strategy aids to reduce the incidence of AL.<\/jats:p>","DOI":"10.1093\/dote\/doad027","type":"journal-article","created":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T06:59:55Z","timestamp":1683529195000},"source":"Crossref","is-referenced-by-count":14,"title":["Laparoscopic ischemic conditioning prior esophagectomy in selected patients: the ISCON trial"],"prefix":"10.1093","volume":"36","author":[{"given":"Eline","family":"de Groot","sequence":"first","affiliation":[{"name":"University Medical Center Utrecht Department of Surgery, , Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars M","family":"Schiffmann","sequence":"additional","affiliation":[{"name":"University of Cologne Department of General, Visceral, Cancer and Transplant Surgery, Faculty of Medicine, , Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjen","family":"van der Veen","sequence":"additional","affiliation":[{"name":"University Medical Center Utrecht Department of Surgery, , Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Borggreve","sequence":"additional","affiliation":[{"name":"University Medical Center Utrecht Department of Surgery, , Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pim","family":"de Jong","sequence":"additional","affiliation":[{"name":"University Medical Center Utrecht and Utrecht University Department of Radiology, Division of Imaging and Oncology, , Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Pinto","family":"Dos Santos","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, University of Cologne, Medical Faculty and University Hospital Cologne , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Babic","sequence":"additional","affiliation":[{"name":"University of Cologne Department of General, Visceral, Cancer and Transplant Surgery, Faculty of Medicine, , Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Fuchs","sequence":"additional","affiliation":[{"name":"University of Cologne Department of General, Visceral, Cancer and Transplant Surgery, Faculty of Medicine, , Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelle","family":"Ruurda","sequence":"additional","affiliation":[{"name":"University Medical Center Utrecht Department of Surgery, , Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Bruns","sequence":"additional","affiliation":[{"name":"University of Cologne Department of General, Visceral, Cancer and Transplant Surgery, Faculty of Medicine, , Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"van Hillegersberg","sequence":"additional","affiliation":[{"name":"University Medical Center Utrecht Department of Surgery, , Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Schr\u00f6der","sequence":"additional","affiliation":[{"name":"University of Cologne Department of General, Visceral, Cancer and Transplant Surgery, Faculty of Medicine, , Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,5,5]]},"reference":[{"key":"2023102807345240700_ref1","doi-asserted-by":"crossref","DOI":"10.1097\/SLA.0000000000002445","article-title":"Defining benchmarks for transthoracic esophagectomy","volume":"266","author":"Schmidt","year":"2017","journal-title":"Ann 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