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      About Digestion: 3.2 Impact Factor I 6.4 CiteScore I 0.914 Scimago Journal & Country Rank (SJR)

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      Cervical or thoracic anastomosis after esophagectomy for cancer: a systematic review and meta-analysis.

      Author(s): 1 , , ,
      Publication date (Electronic):
      Journal: Digestive surgery
      Publisher: S. Karger AG

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          Abstract

          Cervical anastomosis and thoracic anastomosis are used for gastric tube reconstruction after esophagectomy for cancer. This systematic review was conducted in order to identify randomized trials that compare cervical with thoracic anastomosis.

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          Most cited references20

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          The surgical treatment of carcinoma of the oesophagus; with special reference to a new operation for growths of the middle third.

          Fraser I Lewis (1946)
          Article 0 comments Cited 61 times – based on 0 reviews     Review now
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            Total three-stage oesophagectomy for cancer of the oesophagus.

            Catherine K McKeown (1976)
            The technique of total three-stage oesophagectomy is described fully. Points of detail in the procedure of the abdominal, thoracic and cervical phases are emphasized. A brief note is made regarding the management of the respiratory situation at the end of the operation.
            Article 0 comments Cited 42 times – based on 0 reviews     Review now
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              Anastomotic leakage post-esophagogastrectomy for esophageal carcinoma: retrospective analysis of predictive factors, management and influence on longterm survival in a high volume centre.

              J S Rahamim, M. Ali Awan, Sohrab Z. Khan … (2004)
              Anastomotic leak post-gastro-esophagectomy for esophageal carcinoma remains an important issue in immediate as well as late morbidity and mortality. Several predictive factors such as patient and technical variables have been suggested with inconsistent findings. Our aim was to compare these factors and the results of treatment of anastomotic dehiscence on short and longterm survival in our center to published data. A retrospective study of 276 consecutive patients post-Ivor-Lewis gastro-esophagogastrectomy for esophageal carcinoma between 1992 and 1999. Explanatory variables taken into account for predicting anastomotic leak included preoperative weight loss, neoadjuvant therapy, inkwelling of the anastomosis, gastric drainage procedure and involvement of longitudinal resection margins. Incidence variation over time was compared. 5-year survival was assessed using the Kaplan-Meier method. The anastomotic leak rate was 5.1% with only minor variation over time. The 30-day mortality with anastomotic leak was 35.7% compared to 4.2% for patients without leak (P<0.05). None of the suggested explanatory variables analyzed reached statistical significance at a 5% level. On multiple logistic regression there was a trend towards gastric outlet drainage procedure which might decrease the relative risk by 61% (P=0.099). After excluding the 30-day mortality the 5-year survival with anastomotic leak was not different to those without. None of the factors reported in the literature reached statistical significance in our series. High institutional and high surgeon volume seem to outweigh any other contributing factor. Aggressive management for substantial leaks is advocated by the authors as long term palliation does not seem to be affected once the leak has been successfully treated.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Dig Surg
                Title: Digestive surgery
                Publisher: S. Karger AG
                ISSN (Electronic): 1421-9883
                ISSN (Print): 0253-4886
                Publication date (Electronic): 2011
                Volume: 28
                Issue: 1
                Affiliations
                [1 ] Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands. s.biere@vumc.nl
                Article
                Publisher Item ID: 000322014
                DOI: 10.1159/000322014
                PubMed ID: 21293129
                SO-VID: e9566354-c893-4191-9133-b3ca470e37db
                Copyright © Copyright © 2011 S. Karger AG, Basel.
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