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Article: Anastomotic complications after esophagectomy for cancer: A comparison of neck and chest anastomoses

TitleAnastomotic complications after esophagectomy for cancer: A comparison of neck and chest anastomoses
Authors
Issue Date1992
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/jtcvs
Citation
Journal Of Thoracic And Cardiovascular Surgery, 1992, v. 104 n. 2, p. 395-400 How to Cite?
AbstractLeakage, tumor recurrence, and stricture formation at the anastomosis are serious problems after esophagectomy for cancer of the esophagus or cardia. Because the prevalence of these postoperative complications may be affected by whether an anastomosis is made in the neck or in the chest, a comparison was made between anastomoses made at these two sites. During a period of some 7 years, we studied prospectively 411 patients who underwent resection for cancer of the esophagus or cardia and, after immediate reconstruction, had an anastomosis made in the neck or chest. The anastomotic leak rate for the neck anastomosis group was 4.3% and for the chest anastomosis group, 3.7% (p = not significant). The difference between leak rates of anastomoses fashioned by hand-sewn (5.0%) or stapled (3.0%) techniques was also not significant. The median upper resection margins in the neck and chest anastomosis groups were 4.5 cm and 3.5 cm, respectively. The corresponding rates of anastomotic tumor recurrence were 6.1% and 8.1% (p = not significant). The prevalence of benign stricture formation was significantly higher in the chest anastomosis group (19.2%) than in the neck anastomosis group (9.0%) (p = 0.002). This difference was a reflection of a significantly increased prevalence of stricture formation when an anastomosis was made by the stapler technique than with the hand-sewn method, and whereas most of the anastomoses in the neck were hand sewn (90%) the majority of those in the chest were stapled (80%). There were thus no statistically significant differences between the sites in terms of anastomotic leak and tumor recurrence rates, and the higher stricture rate in the chest anastomosis group was the result of more stapled anastomoses.
Persistent Identifierhttp://hdl.handle.net/10722/172679
ISSN
2015 Impact Factor: 3.494
2015 SCImago Journal Rankings: 2.369
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLam, TCFen_US
dc.contributor.authorFok, Men_US
dc.contributor.authorCheng, SWKen_US
dc.contributor.authorWong, Jen_US
dc.date.accessioned2012-10-30T06:24:13Z-
dc.date.available2012-10-30T06:24:13Z-
dc.date.issued1992en_US
dc.identifier.citationJournal Of Thoracic And Cardiovascular Surgery, 1992, v. 104 n. 2, p. 395-400en_US
dc.identifier.issn0022-5223en_US
dc.identifier.urihttp://hdl.handle.net/10722/172679-
dc.description.abstractLeakage, tumor recurrence, and stricture formation at the anastomosis are serious problems after esophagectomy for cancer of the esophagus or cardia. Because the prevalence of these postoperative complications may be affected by whether an anastomosis is made in the neck or in the chest, a comparison was made between anastomoses made at these two sites. During a period of some 7 years, we studied prospectively 411 patients who underwent resection for cancer of the esophagus or cardia and, after immediate reconstruction, had an anastomosis made in the neck or chest. The anastomotic leak rate for the neck anastomosis group was 4.3% and for the chest anastomosis group, 3.7% (p = not significant). The difference between leak rates of anastomoses fashioned by hand-sewn (5.0%) or stapled (3.0%) techniques was also not significant. The median upper resection margins in the neck and chest anastomosis groups were 4.5 cm and 3.5 cm, respectively. The corresponding rates of anastomotic tumor recurrence were 6.1% and 8.1% (p = not significant). The prevalence of benign stricture formation was significantly higher in the chest anastomosis group (19.2%) than in the neck anastomosis group (9.0%) (p = 0.002). This difference was a reflection of a significantly increased prevalence of stricture formation when an anastomosis was made by the stapler technique than with the hand-sewn method, and whereas most of the anastomoses in the neck were hand sewn (90%) the majority of those in the chest were stapled (80%). There were thus no statistically significant differences between the sites in terms of anastomotic leak and tumor recurrence rates, and the higher stricture rate in the chest anastomosis group was the result of more stapled anastomoses.en_US
dc.languageengen_US
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/jtcvsen_US
dc.relation.ispartofJournal of Thoracic and Cardiovascular Surgeryen_US
dc.subject.meshAnastomosis, Surgical - Methodsen_US
dc.subject.meshCarcinoma, Squamous Cell - Surgeryen_US
dc.subject.meshConstriction, Pathologic - Epidemiologyen_US
dc.subject.meshEsophageal Neoplasms - Surgeryen_US
dc.subject.meshEsophagectomy - Adverse Effectsen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNecken_US
dc.subject.meshNeoplasm Recurrence, Local - Epidemiologyen_US
dc.subject.meshPrevalenceen_US
dc.subject.meshSurgical Staplersen_US
dc.subject.meshSurgical Wound Dehiscence - Epidemiologyen_US
dc.subject.meshSuture Techniquesen_US
dc.subject.meshThoraxen_US
dc.titleAnastomotic complications after esophagectomy for cancer: A comparison of neck and chest anastomosesen_US
dc.typeArticleen_US
dc.identifier.emailCheng, SWK: wkcheng@hkucc.hku.hken_US
dc.identifier.authorityCheng, SWK=rp00374en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid1495302-
dc.identifier.scopuseid_2-s2.0-0026804641en_US
dc.identifier.volume104en_US
dc.identifier.issue2en_US
dc.identifier.spage395en_US
dc.identifier.epage400en_US
dc.identifier.isiWOS:A1992JH47500023-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridLam, TCF=7202522854en_US
dc.identifier.scopusauthoridFok, M=7005879262en_US
dc.identifier.scopusauthoridCheng, SWK=7404684779en_US
dc.identifier.scopusauthoridWong, J=7404435808en_US

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