Abstract

Abstract Anastomotic stenosis after esophagectomy is a major cause of long-term morbidity because it leads to poor dietary intake and malnutrition that markedly reduces quality of life. The aim of this study was to test the hypothesis that the risk of anastomotic stenosis is higher when the anastomosis is located behind the sternoclavicular joint than when it deviates from the sternoclavicular joint. Methods Among 226 patients who underwent esophagectomy between April 2010 and March 2019, we selected 114 patients who underwent retrosternal reconstruction using a gastric conduit for this study. They were classified into two groups according to the location of the anastomosis as determined by postoperative computed tomography scans: anastomosis located behind the sternoclavicular joint (group B; n = 71) and anastomosis deviated from the joint (group D; n = 43). The primary endpoint was the difference in the incidence of anastomotic stenosis between the two groups. Whether the occurrence of anastomotic leak affected the likelihood of anastomotic stenosis was also investigated. Results The incidence of anastomotic stenosis was significantly higher in group B than in group D (71.8% [n = 51] vs 18.6% [n = 8]; p < 0.0001). The incidence of stenosis in patients who developed an anastomotic leak was significantly higher in group B than in group D (88.0% vs 41.7%; p = 0.0057), although the findings were similar in patients who did not develop an anastomotic leak (63.0% and 9.7%, respectively; p < 0.0001). Conclusion There is an increased risk of anastomotic stenosis independent of anastomotic leak when the anastomosis is located behind the sternoclavicular joint in patients who undergo retrosternal reconstruction with a gastric conduit after esophagectomy.

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.