Predictors and outcome of cervical anastomotic leakage after esophageal cancer surgery

Abstract

Preoperative conditions like hypertension and higher creatinine levels predict development of cervical anastomotic leakage after esophageal cancer surgery. Postoperative consequences accompanying leakage include pulmonary complication and prolonged hospitalization.

Association between Physical Activity and Postoperative Complications after Esophagectomy for Cancer: A Prospective Observational Study

“…Generally, there is an inverse linear relationship between physical activity level and all-cause mortality; this is commonly because of lifestyle-related disease (Lee and Skerrett, 2001;Ismail-Beigi, 2012). In our study, the incidence of anastomotic leakage was 16%, which is comparable to the incidence reported in other series (Rutegård et al, 2009;Aminian et al, 2011). The most important predisposing factor for anastomotic leakage is ischemia of gastric conduit (Urschel, 1995).…”

“…The most important predisposing factor for anastomotic leakage is ischemia of gastric conduit (Urschel, 1995). One previous study has also reported history of hypertension and diabetes mellitus as independent risk factors for anastomotic leakage, possibly due to reduced microperfusion of tissues (Aminian et al, 2011). In the present study, the patients with highlevel physical activity may have had a reduced risk of anastomotic leakage by maintaining a better circulation.…”

A non-randomized retrospective observational study on the subcutaneous esophageal reconstruction after esophagectomy: is it feasible in high-risk patients?

“…The main reasons for the selection of the subcutaneous route were the intraoperative findings such as poor blood supply, unsatisfactory graft color, edematous change of the graft, and preoperative comorbidities such as old age (>70 years), hypertension, diabetes, heavy current smoking with emphysematous lung, chronic alcohol abuse with liver cirrhosis, chronic kidney disease, or stroke histories ( Table 1). Our decisions were based on the idea that such preoperative and intraoperative findings may act as the risk factors for major morbidities including anastomotic leakages as reported in many previous studies (2,5,6). Therefore, we assumed that this rather less cosmetic and unorthodox method could be more appropriate for high-risk patients in terms of perioperative safety.…”

“…Preoperative comorbidities such as hypertension, diabetes, serum levels of creatinine, old age (>75 years), congestive heart failure, coronary artery disease, peripheral vascular disease, renal insufficiency, and heavy smoking were reported to be strong predictors of major morbidity after esophagectomy (2,5,6). Therefore, when planning for esophagectomy and reconstruction for patients with comorbidities, careful attention should be paid to the possibility of anastomotic failure.…”

“…Esophagectomy and esophageal reconstruction is a complex invasive procedure with high morbidity (40%) and mortality (5-10%) rates (1,2). According to previous studies, the presence of comorbidities such as old age, hypertension, diabetes, smoking status, congestive heart failure, coronary artery disease, poor preoperative pulmonary function, and high preoperative serum creatinine level worsens the clinical outcomes including anastomotic leakage, pulmonary complications, and overall survival (2-7).…”