The Esophageal Anastomosis: How Improving Blood Supply Affects Leak Rate

Cervical or Thoracic Anastomosis after Esophagectomy for Cancer: A Systematic Review and Meta-Analysis

“…The location of the anastomosis could be a risk factor for leakage. However, cervical anastomoses could suffer more than thoracic anastomoses from ischemia of the gastric conduit [12,13]. Other possible factors that could contribute to leakage could be of a technical nature, related to gastric drainage or low institution and surgeon volume [14,15].…”

Effect of Preoperative Single-Dose Corticosteroid Administration on Postoperative Morbidity Following Esophagectomy

“…44 Blood supply during esophagectomy is a major concern to the surgeon. 48 Glucocorticoids were reported to initiate human 49 and mouse [49][50][51] fibroblasts proliferation using in vitro models. These actions occur only in presence of fibroblast growth factors.…”

Esophageal anastomosis - how the granulation phase of wound healing improves the incidence of anastomotic leakage

“…In general, tension-free suturing and excellent blood perfusion lead to primary spontaneous healing of anastomoses (2)(3)(4)(5)36). In pathological conditions, including systemic or local severe inflammation and ischemia, the healing process may be impaired and result in the occurrence of fistulas or fibrosis, subsequently leading to stenosis of the site of the anastomosis.…”

“…Each route of transposition has advantages, but are often under debate, since the posterior route is shorter than the anterior route, but mediastinal leakage is more dangerous than leakage on the neck. Anastomotic leakage is a feared complication of reconstruction with an incidence of 3-30% and a mortality rate of 25-50% (2)(3)(4)(5)(6)(7).…”