Observational studyThe British journal of surgery2023
Treatment of anastomotic leak after oesophagectomy for oesophageal cancer: large, collaborative, observational TENTACLE cohort study.
Observational study in The British journal of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis 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.
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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
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- International Society for Diseases of the Esophagus consensus on the diagnosis and treatment of anastomotic leak after esophagectomy.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2026Guideline
- Infection-targeted innovations in anastomotic leak management: endoscopic advances, antimicrobial biomaterials, and precision strategies.Annals of medicine · 2026Review
- Ultra-early postoperative endoscopy reduces anastomotic leak after minimally invasive esophagectomy: a propensity score-matched study.Surgical endoscopy · 2026Article
- Endoscopic vacuum-assisted closure as a first-line treatment for post-esophagectomy anastomotic leaks: A paradigm shift in management.World journal of gastrointestinal surgery · 2025Review
- Stenting Versus Endoscopic Vacuum Therapy for Anastomotic Leakage After Esophago-Gastric Surgery.Journal of clinical medicine · 2025Article
- Addressing Anastomotic Leak After Esophagectomy: Insights from a Specialized Unit.Journal of clinical medicine · 2025Article
- TreatmENT of AnastomotiC LeakagE after colon cancer resection: the TENTACLE - Colon study.BMC surgery · 2025Article
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- Successful closure of a complex tracheoesophageal fistula: An endoscopic intervention strategy based on tracheal stent transition.Science progressArticle
Corrections and comments
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Authors and funding
20 authors at 11 institutions in 3 countries.
Funding
Abstract
backgroundAnastomotic leak is a severe complication after oesophagectomy. Anastomotic leak has diverse clinical manifestations and the optimal treatment strategy is unknown. The aim of this study was to assess the efficacy of treatment strategies for different manifestations of anastomotic leak after oesophagectomy.
methodsA retrospective cohort study was performed in 71 centres worldwide and included patients with anastomotic leak after oesophagectomy (2011-2019). Different primary treatment strategies were compared for three different anastomotic leak manifestations: interventional versus supportive-only treatment for local manifestations (that is no intrathoracic collections; well perfused conduit); drainage and defect closure versus drainage only for intrathoracic manifestations; and oesophageal diversion versus continuity-preserving treatment for conduit ischaemia/necrosis. The primary outcome was 90-day mortality. Propensity score matching was performed to adjust for confounders.
resultsOf 1508 patients with anastomotic leak, 28.2 per cent (425 patients) had local manifestations, 36.3 per cent (548 patients) had intrathoracic manifestations, 9.6 per cent (145 patients) had conduit ischaemia/necrosis, 17.5 per cent (264 patients) were allocated after multiple imputation, and 8.4 per cent (126 patients) were excluded. After propensity score matching, no statistically significant differences in 90-day mortality were found regarding interventional versus supportive-only treatment for local manifestations (risk difference 3.2 per cent, 95 per cent c.i. -1.8 to 8.2 per cent), drainage and defect closure versus drainage only for intrathoracic manifestations (risk difference 5.8 per cent, 95 per cent c.i. -1.2 to 12.8 per cent), and oesophageal diversion versus continuity-preserving treatment for conduit ischaemia/necrosis (risk difference 0.1 per cent, 95 per cent c.i. -21.4 to 1.6 per cent). In general, less morbidity was found after less extensive primary treatment strategies.
conclusionLess extensive primary treatment of anastomotic leak was associated with less morbidity. A less extensive primary treatment approach may potentially be considered for anastomotic leak. Future studies are needed to confirm current findings and guide optimal treatment of anastomotic leak after oesophagectomy.
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