ArticleLangenbeck's archives of surgery2015
Outcome, complications, and mortality of an intrathoracic anastomosis in esophageal cancer in patients without a preoperative selection with a risk score.
Article in Langenbeck's archives of surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 21 citations in OpenAlex.
- Identification of recurrence risk factors and development of personalized follow-up strategies for esophageal squamous cell carcinoma patients after neoadjuvant therapy and surgery: a retrospective cohort study.Journal of thoracic disease · 2026Article
- Anastomotic leakage following resection of the esophagus-introduction of an endoscopic grading system.World journal of surgical oncology · 2022Article
- Conditional survival after neoadjuvant chemoradiotherapy and surgery for oesophageal cancer.The British journal of surgery · 2020Article
- Immediate extubation after esophagectomy with three-field lymphadenectomy enables early ambulation in patients with thoracic esophageal cancer.Esophagus : official journal of the Japan Esophageal Society · 2018Article
- Calcification score versus arterial stenosis grading: comparison of two CT-based methods for risk assessment of anastomotic leakage after esophagectomy and gastric pull-up.Therapeutics and clinical risk management · 2018Article
- Perioperative outcomes of esophageal cancer surgery in a mid-volume institution in the era of centralization.Langenbeck's archives of surgery · 2016Article
- [Endoscopic therapy of esophageal diseases].Der Internist · 2016Review
- Evidence-Based Operative Details in Esophageal Cancer Treatment: Surgical Approach, Lymphadenectomy, Anastomosis.Viszeralmedizin · 2015Review
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEsophagectomy for esophageal cancer remains a challenge with relatively high morbidity. We analyzed outcome, complications, and mortality after abdominothoracic esophagectomy with intrathoracic anastomosis. No routine preoperative risk stratification was performed.
methodsOne hundred eighty-seven consecutive patients (105 AEG I, 21 AEG II, 58 SCC, and 3 other entities) underwent standardized right abdominothoracic esophagectomy with intrathoracic anastomosis and two field lymphadenectomy between 2003 and 2009. Reconstruction was performed mostly with a gastric tube (n = 126) or a fundus rotation gastroplasty (n = 57). Seventy-four patients underwent neoadjuvant treatment (36 patients chemotherapy; 38 patients chemoradiotherapy).
resultsPostoperative morbidity was high (73.2 %). Ninety-two patients (49.2 %) suffered from surgical complications, 50 patients had major (26.7 %), and 42 minor (22.5 %) complications. Thirty-day mortality was 9/187 (4.8 %) while in-hospital mortality was doubled with 9.6 %. Six of 19 of the patients died without surgical complications. Preoperative treatment did not increase morbidity or mortality. Surgical complications with subsequent death were tracheobronchial fistula (2/3), ischemia of the gastric tube (3/6), anastomotic leakage (6/30), chylothorax (1/6), and intraoperative bleeding from the aorta (1/1). The median overall survival was 25.0 months. The occurrence of surgical or medical complications did not influence overall survival. In multivariate analysis, cT-category, pN-category, R-category, and re-intubation were independent prognostic factors.
conclusionsAbdominothoracic esophagectomy with intrathoracic anastomosis without preoperative patient selection is associated with a high risk for complications and subsequent death but ranges still within the upper range of published data. Strict patient selection is accepted to reduce postoperative morbidity and mortality but excludes a subgroup of patients from potentially curative resection.
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