Korean J Thorac Cardiovasc Surg.  2006 Mar;39(3):208-213.

Anastomotic Leakage and Stricture Relating to Anastomotic Level and Methods in Esophageal Resection and Reconstruction for Esophageal Cancer

• Shin HJ
• Kim CW
• Park SI
• Kim YH
• Kim DK
• Park SI

Abstract

BACKGROUND: The prevalence of anastomotic complication is related to anastomotic procedure or site in esophageal cancer operation. We studied the anastomotic leakage and stricture related to the anastomotic procedure &site in patients who received the esophageal resection and reconstruction for esophageal cancer. MATERIAL AND METHOD: The anastomotic procedure, site and complication of 321 patients who received the esophageal reconstruction from August 1993 to May 2003 were investigated. Mean age was 64.5+/-4.9 (37~94) years, 300 patients (93.5%) were male and 21 patients were female (6.5%). RESULT: There were 7 anastomotic leakages (2.2%) and no difference in anastomotic site (cervical anastomosis 4.1%, thoracic anastomosis 1.6%) and procedure (stapler technique 1.6%, semi-staple technique 9.1%, hand-sewn technique 0.0%). There were 52 anastomotic strictures (16.2%), differences in sites (cervical anastomosis 2.7%, thoracic anastomosis 20.2%) (p <0.001) and procedure (stapler technique 20.0%, semi-stapler technique 3.0%, hand-sewn technique 4.7%). And the stapler technique showed higher stricture rate (p <0.001).
CONCLUSION
Anastomotic technique was less related to anastomotic leakage in esophageal reconstruction for esophageal cancer. However, stapler technique had higher stricture rate than other techniques. Therefore, we suggest that the anastomotic technique be improved to reduce anastomotic stricture.

Keyword

Esophageal neoplasms; Esophageal surgery; Stricture; Leakage

MeSH Terms

Anastomotic Leak*
Constriction, Pathologic*
Esophageal Neoplasms*
Female
Humans
Male
Prevalence