ArticleEsophagus : official journal of the Japan Esophageal Society2025
Modification of the lesser curvature incision line enhanced gastric conduit perfusion as determined by indocyanine green fluorescence imaging and decreased the incidence of anastomotic leakage following esophagectomy.
Article in Esophagus : official journal of the Japan Esophageal Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Association Between Thoracic Inlet Size and Cervical Anastomosis Outcomes in Esophageal Cancer Surgery.Current oncology (Toronto, Ont.) · 2026Article
- Advances in Minimally Invasive Esophagectomy-An Overview of Recent Developments and a Novel Classification of Innovations in Treatment of Thoracic Esophageal Cancer.Medicina (Kaunas, Lithuania) · 2025Review
- Indocyanine green fluorescence imaging in gastric cancer: Clinical efficacy, technical innovations, and future perspectives.World journal of gastrointestinal surgery · 2025Review
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10 authors.
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Abstract
aimThis study aimed to investigate the effectiveness of a modified incision line on the lesser curvature for gastric conduit formation during esophagectomy in enhancing the perfusion of gastric conduit as determined by indocyanine green fluorescence imaging and reducing the incidence of anastomotic leakage.
methodsA total of 272 patients who underwent esophagectomy at our institute between 2014 and 2022 were enrolled in this study. These patients were divided based on two different types of cutlines on the lesser curvature: conventional group (n = 141) following the traditional cutline and modified group (n = 131) adopting a modified cutline. Gastric conduit perfusion was assessed by ICG fluorescence imaging, and clinical outcomes after esophagectomy were evaluated.
resultsThe distance from the pylorus to the cutline was significantly longer in the modified group compared with the conventional group (median: 9.0 cm vs. 5.0 cm, p < 0.001). The blood flow speed in the gastric conduit wall was significantly higher in the modified group than that in the conventional group (median: 2.81 cm/s vs. 2.54 cm/s, p = 0.001). Furthermore, anastomotic leakage was significantly lower (p = 0.024) and hospital stay was significantly shorter (p < 0.001) in the modified group compared with the conventional group. Multivariate analysis identified blood flow speed in the gastric conduit wall as the only variable significantly associated with anastomotic leakage.
conclusionsICG fluorescence imaging is a feasible, reliable method for the assessment of gastric conduit perfusion. Modified lesser curvature cutline could enhance gastric conduit perfusion, promote blood circulation around the anastomotic site, and reduce the risk of anastomotic leakage after esophagectomy.
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