ReviewAnnals of translational medicine2021
Progress in the esophagogastric anastomosis and the challenges of minimally invasive thoracoscopic surgery.
Review in Annals of translational medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Stapled vs. hand-sewn anastomosis during esophagectomy: a randomized trials systematic review and meta-analysis.Updates in surgery · 2026Pooled it
- Esophagectomy in patients with liver cirrhosis: systematic review and meta-analysis of short-term outcomes.Updates in surgery · 2025Pooled it
- The Application of a Mechanical Side-to-Side Oesophagogastric Anastomosis in the Reconstruction of the Digestive Tract After an Oesophagectomy in a Beagle Model.Interdisciplinary cardiovascular and thoracic surgery · 2026Article
- Impact of Anastomotic Leaks on Long-Term Survival in Patients with Esophageal Squamous Cell Carcinoma Following McKeown Esophagectomy: A Propensity Score-Matched Analysis.Annals of surgical oncology · 2025Article
- Does Indocyanine Green Utilization during Esophagectomy Prevent Anastomotic Leaks? Systematic Review and Meta-Analysis.Journal of clinical medicine · 2024Review
- Attenuation of esophageal anastomotic stricture through remote ischemic conditioning in a rat model.Scientific reports · 2024Article
- Placing vacuum sponges in esophageal anastomotic leaks - how we do it.Langenbeck's archives of surgery · 2024Article
- Robot-assisted esophagectomy with robot-sewn intrathoracic anastomosis (Ivor Lewis): surgical technique and early results.Updates in surgery · 2023Article
- Purse-indigitation mechanical anastomosisAnnals of translational medicine · 2022Article
- Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The esophagogastric anastomosis is most commonly performed to restore digestive tract continuity after esophagectomy for cancer. Despite a long history of clinical research and development of high-tech staplers, this procedure is still feared by most surgeons and associated with a 10% leakage rate. Among specific factors that may contribute to failure of the esophageal anastomosis are the absence of serosa layer, longitudinal orientation of muscle fibers, and ischemia of the gastric conduit. It has recently been suggested that the gut microbiome may influence the healing process of the anastomosis through the presence of collagenolytic bacterial strains, indicating that suture breakdown is not only a matter of collagen biosynthesis. The esophagogastric anastomosis can be performed either in the chest or neck, and can be completely hand-sewn, completely stapled (circular or linear stapler), or semi-mechanical (linear stapler posterior wall and hand-sewn anterior wall). Because of the lack of randomized clinical trials, no conclusive evidence is available, and the debate between the hand-sewn and the stapling technique is still ongoing even in the present era of robotic surgery. Centralization of care has improved the overall postoperative outcomes of esophagectomy, but the esophagogastric anastomosis remains the Achille's heel of the procedure. More research and network collaboration of experts is needed to improve safety and clinical outcomes.
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