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- Title
Prevalence and outcome of esophagogastric anastomotic leak after esophagectomy in a UK regional cancer network.
- Authors
Escofet, X.; Manjunath, A.; Twine, C.; Havard, T. J.; Clark, G. W.; Lewis, W. G.
- Abstract
The aim of this study was to determine the contemporary prevalence, outcome, and survival after esophagogastric anastomotic leakage (EGAL) following esophagectomy by a regional upper gastrointestinal cancer network and to investigate etiological factors. Two hundred forty consecutive patients underwent esophagectomy over a 10-year period (median age 61 [31–79] years, 147 transthoracic and 93 transhiatal esophagectomy, 105 neoadjuvant chemotherapy, 49 chemoradiotherapy). The primary outcome measures were the development of EGAL and survival. Twenty patients developed EGAL (8.3%, 15 managed conservatively, 5 reoperation). Overall operative mortality was 2% (5 patients in total, 1 after EGAL). Median, 1 and 2-year survival was 22 months, 73% and 50%, in patients after EGAL, compared with 31 months, 80% and 56%, in patients who did not suffer EGAL ( P= 0.314). On multivariate analysis, low body mass indices (hazard ratio [HR] 0.29, 95% confidence interval [CI] 0.11–0.79, P= 0.016), individual surgeon (HR 1.21, 95% CI 1.02–1.43, P= 0.02), and neoadjuvant chemotherapy (HR 3.28, 95% CI 1.16–9.22, P= 0.024) were significantly associated with the development of EGAL. EGAL following esophagectomy remained common, but associated mortality was less common than reported in earlier Western series and long-term survival was unaffected.
- Subjects
UNITED Kingdom; ESOPHAGOGASTRIC junction; ESOPHAGECTOMY; CANCER patients; PHARMACOLOGY
- Publication
Diseases of the Esophagus, 2010, Vol 23, Issue 2, p112
- ISSN
1120-8694
- Publication type
Article
- DOI
10.1111/j.1442-2050.2009.00995.x