Association of level of anastomosis and anastomotic leak after esophagectomy in anterior mediastinal reconstruction

Association of level of anastomosis and anastomotic leak after esophagectomy in anterior... Aim The purpose of this study was to investigate modifiable predisposing factors associated with anastomotic leak in the anterior mediastinal (AM) reconstruction route. Methods We reviewed the data on 154 patients who underwent esophagectomy and gastric tube reconstruction using the AM route between 2008 and 2016. The data included computed tomography (CT) scans with sagittal reconstruction of the thoracic section. The level of the esophagogastric anastomosis (LEA) and pretracheal distance (PTD) was measured from sagittal reconstructed CT images. Vascularization of the gastric tube was evaluated by postoperative endoscopy. Variables associated with anastomotic leak were determined using univariate and multivariate analyses. Results Anastomotic leak developed in 13 patients (8%). The cut-off level at which the anastomosis was less likely to develop a leak, as determined by Chi-square tests, was 1.5 cm for LEA and 1.3 cm for PTD. On univariate analysis, the factors that were significantly associated with the risk of anastomotic leak included diabetes, hand-sewn anastomosis, the LEA ≥ 1.5 cm, and severe mucosal degeneration. On multivariate analysis, diabetes (OR 4.7, 95% CI 1.29–17.2), LEA ≥ 1.5 cm (OR 20.1, 95% CI 3.15–128), and severe mucosal degeneration (OR 7.2, 95% CI 1.42–36.8) were found to be statistically significant independent risk factors. Conclusion Use http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Esophagus Springer Journals

Association of level of anastomosis and anastomotic leak after esophagectomy in anterior mediastinal reconstruction

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Publisher
Springer Japan
Copyright
Copyright © 2018 by The Japan Esophageal Society and Springer Japan KK, part of Springer Nature
Subject
Medicine & Public Health; Gastroenterology; Thoracic Surgery; Surgical Oncology
ISSN
1612-9059
eISSN
1612-9067
D.O.I.
10.1007/s10388-018-0619-7
Publisher site
See Article on Publisher Site

Abstract

Aim The purpose of this study was to investigate modifiable predisposing factors associated with anastomotic leak in the anterior mediastinal (AM) reconstruction route. Methods We reviewed the data on 154 patients who underwent esophagectomy and gastric tube reconstruction using the AM route between 2008 and 2016. The data included computed tomography (CT) scans with sagittal reconstruction of the thoracic section. The level of the esophagogastric anastomosis (LEA) and pretracheal distance (PTD) was measured from sagittal reconstructed CT images. Vascularization of the gastric tube was evaluated by postoperative endoscopy. Variables associated with anastomotic leak were determined using univariate and multivariate analyses. Results Anastomotic leak developed in 13 patients (8%). The cut-off level at which the anastomosis was less likely to develop a leak, as determined by Chi-square tests, was 1.5 cm for LEA and 1.3 cm for PTD. On univariate analysis, the factors that were significantly associated with the risk of anastomotic leak included diabetes, hand-sewn anastomosis, the LEA ≥ 1.5 cm, and severe mucosal degeneration. On multivariate analysis, diabetes (OR 4.7, 95% CI 1.29–17.2), LEA ≥ 1.5 cm (OR 20.1, 95% CI 3.15–128), and severe mucosal degeneration (OR 7.2, 95% CI 1.42–36.8) were found to be statistically significant independent risk factors. Conclusion Use

Journal

EsophagusSpringer Journals

Published: May 31, 2018

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