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World Journal of Surgery

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01-10-2017 | Original Scientific Report

Superior Thoracic Aperture Size is Significantly Associated with Cervical Anastomotic Leakage After Esophagectomy

Authors: Shinji Mine, Masayuki Watanabe, Akihiko Okamura, Yu Imamura, Yoshiaki Kajiyama, Takeshi Sano

Published in: World Journal of Surgery | Issue 10/2017

Abstract

Background

The size of the superior thoracic aperture (STA) may be associated with the incidence of cervical anastomotic leakage after esophagectomy. Using computed tomography (CT) images, we retrospectively investigated relationships between the size of the STA and anastomotic leakage following esophagectomy using the retrosternal or posterior mediastinal reconstruction routes.

Methods

Patients who underwent cervical esophagogastrostomy after esophagectomy between 2009 and 2015 were enrolled in this retrospective study (n = 326). The size of the STA was measured at the level of the sternal notch using preoperative CT images, and it was determined as the anteroposterior diameter of the STA minus the diameter of the trachea. Associations between clinical factors, including the size of the STA, and anastomotic leakage were determined.

Results

Anastomotic leakage occurred in 44 patients (13.5%). The size of the STA ranged from 0 to 49 mm (median, 16 mm). In univariate analyses, the duration of the operation, tumor location, anastomotic procedure, and the size of the STA were significantly associated with anastomotic leakage. In multivariate analysis, only the size of the STA was independently related to leakage (odds ratio 1.05; 95% confidence interval 1.002–1.107; p = 0.027). The size of the STA affected the incidence of leakage more frequently with the posterior mediastinal route than with the retrosternal route.

Conclusions

The size of the STA was significantly associated with the incidence of anastomotic leakage after esophagectomy, especially when using the posterior mediastinal route.

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Title: Superior Thoracic Aperture Size is Significantly Associated with Cervical Anastomotic Leakage After Esophagectomy
Authors: Shinji Mine
Masayuki Watanabe
Akihiko Okamura
Yu Imamura
Yoshiaki Kajiyama
Takeshi Sano
Publication date: 01-10-2017
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 10/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-017-4047-y

At a glance: The STEP trials

Springer Medicine

Superior Thoracic Aperture Size is Significantly Associated with Cervical Anastomotic Leakage After Esophagectomy

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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