Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Institute of Health Policy Management and Evaluation, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada.
BMJ Open. 2024 Jun 11;14(6):e081153. doi: 10.1136/bmjopen-2023-081153.
Oesophageal discontinuity remains a challenge for thoracic and foregut surgeons globally. Whether arising emergently after catastrophic oesophageal or gastric disruption or arising in the elective setting in the case of staged reconstruction for esophagectomy or long gap atresia in the paediatric population, comprehensive review of this patient population remains unexplored within the surgical literature.The goal of this scoping review is to map the landscape of literature exploring the creation and takedown of cervical oesophagostomy with the intent to answer four questions (1) What are the primary indications for oesophageal discontinuity procedures? (2) What are the disease-specific and healthcare utilisation outcomes for oesophageal discontinuity procedures? (3) What is the primary indication for reversal procedures? (4) What are the disease-specific and healthcare utilisation outcomes for reversal procedures?
This review will follow the Arksey and O'Malley (2005) framework for scoping reviews. Paediatric (<18 years old) and adult (>18 years old) patients, who have received a cervical oesophagostomy in the context of a gastrointestinal discontinuity procedure or those who have had reversal of a cervical oesophagostomy, will be included for analysis. We will search MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) databases for papers from 1990 until 2023. Interventional trials, prospective and retrospective observational studies, reviews, case series and qualitative study designs will be included. Two authors will independently review all titles, abstracts and full texts to determine which studies meet the inclusion criteria.
No ethics approval is required for this review. Results will be disseminated through scientific presentations and relevant conferences targeted for researchers examining upper gastrointestinal/foregut surgery.
This protocol is registered with Open Science Framework (osf.io/s3b4g).
食管连续性的中断仍然是全球胸外科和前肠外科医生面临的挑战。无论是在灾难性食管或胃破裂后紧急发生，还是在食管切除术或儿童长段食管闭锁的分期重建的择期情况下发生，对这类患者人群的综合回顾在外科文献中仍未得到探索。本范围综述的目的是绘制探索颈段食管造口术建立和拆除的文献图谱，旨在回答四个问题：（1）食管中断手术的主要适应证是什么？（2）食管中断手术的疾病特异性和医疗保健利用结果如何？（3）逆转手术的主要适应证是什么？（4）逆转手术的疾病特异性和医疗保健利用结果如何？
本综述将遵循 Arksey 和 O'Malley（2005 年）的范围综述框架。纳入分析的患者为在胃肠道连续性手术中接受过颈段食管造口术或进行过颈段食管造口术逆转的儿科（<18 岁）和成人（>18 岁）患者。我们将检索 1990 年至 2023 年 MEDLINE、EMBASE 和 Cochrane 对照试验中心注册库（CENTRAL）中的文献。纳入的研究设计包括干预性试验、前瞻性和回顾性观察性研究、综述、病例系列和定性研究。两名作者将独立审查所有标题、摘要和全文，以确定符合纳入标准的研究。
本综述不需要伦理批准。研究结果将通过科学演讲和针对研究上消化道/前肠手术的相关会议进行传播。
本方案在开放科学框架（osf.io/s3b4g）上注册。
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