Intrathoracic versus cervical anastomosis and predictors of anastomotic leakage after oesophagectomy for cancer. BJS 2018; 105: 552-560.
Published: 7th February 2018
Authors: J. A. H. Gooszen, L. Goense, S. S. Gisbertz, J. P. Ruurda, R. van Hillegersberg, M. I. van Berge Henegouwen et al.
Studies comparing the anastomotic leak rate in patients with an intrathoracic
Between January 2011 and December 2015, all consecutive patients who underwent oesophagectomy for cancer were identified from the Dutch Upper Gastrointestinal Cancer Audit. For the comparison between an intrathoracic and cervical anastomosis, propensity score matching was used to adjust for potential confounders. Multivariable logistic regression modelling with backward stepwise selection was used to determine independent predictors of anastomotic leakage.
Some 3348 patients were included. After propensity score matching, 654 patients were included in both the cervical and intrathoracic anastomosis groups. An intrathoracic anastomosis was associated with a lower leak rate than a cervical anastomosis (17·0
An intrathoracic oesophagogastric anastomosis was associated with a lower anastomotic leak rate, lower rate of recurrent nerve paresis and a shorter hospital stay. Risk factors for anastomotic leak were co‐morbidities and proximal tumours.Full text
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