End-to-End Cervical Esophagogastric Anastomoses Are Associated with a Higher Number of Strictures Compared with End-to-Side Anastomoses
Background Leakage and benign strictures occur frequently after esophagectomy. The objective of this study was to analyze the outcome of hand-sewn end-to-end versus end-to-side cervical esophagogastric anastomoses. Methods A series of 390 consecutive patients who underwent esophagectomy with gastric...
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| Veröffentlicht in: | Journal of gastrointestinal surgery 2013-05, Vol.17 (5), p.872-876 |
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| creator | Haverkamp, Leonie van der Sluis, Pieter C. Verhage, Roy J. J. Siersema, Peter D. Ruurda, Jelle P. van Hillegersberg, Richard |
| description | Background
Leakage and benign strictures occur frequently after esophagectomy. The objective of this study was to analyze the outcome of hand-sewn end-to-end versus end-to-side cervical esophagogastric anastomoses.
Methods
A series of 390 consecutive patients who underwent esophagectomy with gastric conduit reconstruction was analyzed.
Results
The end-to-end technique was performed in 112 (29 %) patients and the end-to-side in 278 (71 %) patients. Anastomotic leakage occurred in 20 (18 %) patients with an end-to-end anastomosis versus 58 (21 %) patients with an end-to-side anastomosis (
p
= 0.50). A higher incidence in anastomotic strictures was seen in end-to-end anastomoses (48 (43 %)) compared with end-to-side anastomoses (89 (32 %);
p
= 0.04). Moreover, a median of 11 (7–17) dilations was necessary in patients with a benign anastomotic stricture in the end-to-end group compared with four (2–8) dilations in patients with a benign anastomotic stricture in the end-to-end group (
p
|
| doi_str_mv | 10.1007/s11605-013-2159-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1326142980</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1326142980</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-197f27fd9b15a60e075988364634c140564e2df963cc981399dc588639c83dc63</originalsourceid><addsrcrecordid>eNp1kUFrGzEQhUVJaNK0P6CXIsilF7Uz0korHY1x60JoD0kgNyFrtfYG78qRdhP6C_q3K2OnhEBPb2C-92bgEfIR4QsC1F8zogLJAAXjKA3Tb8g56lqwSnF1UmYwyLiUd2fkXc73AFgD6rfkjIsKQII5J38WQ8PGyIrQeUiPnXdbushxt3HruHZ5TJ2ns6EMsY85ZDpLgc5yjr5zY2joUzduqKPLbr0Jif6c-lWR2NLrvXGcUnHMY79z6Zk93rvumvAy9z05bd02hw9HvSC33xY38yW7-vX9x3x2xbyo-cjQ1C2v28asUDoFAWpptBaqUqLyWIFUVeBNa5Tw3mgUxjReaq2E8Vo0XokL8vmQu0vxYQp5tH2Xfdhu3RDilC0KrrDiRkNBL1-h93FKQ_luT0nk3EBdKDxQPsWcU2jtLnW9S78tgt23ZA8t2dKS3bdkdfF8OiZPqz40_xzPtRSAH4BcVsM6pBen_5v6F86ZnBs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1325122907</pqid></control><display><type>article</type><title>End-to-End Cervical Esophagogastric Anastomoses Are Associated with a Higher Number of Strictures Compared with End-to-Side Anastomoses</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Haverkamp, Leonie ; van der Sluis, Pieter C. ; Verhage, Roy J. J. ; Siersema, Peter D. ; Ruurda, Jelle P. ; van Hillegersberg, Richard</creator><creatorcontrib>Haverkamp, Leonie ; van der Sluis, Pieter C. ; Verhage, Roy J. J. ; Siersema, Peter D. ; Ruurda, Jelle P. ; van Hillegersberg, Richard</creatorcontrib><description>Background
Leakage and benign strictures occur frequently after esophagectomy. The objective of this study was to analyze the outcome of hand-sewn end-to-end versus end-to-side cervical esophagogastric anastomoses.
Methods
A series of 390 consecutive patients who underwent esophagectomy with gastric conduit reconstruction was analyzed.
Results
The end-to-end technique was performed in 112 (29 %) patients and the end-to-side in 278 (71 %) patients. Anastomotic leakage occurred in 20 (18 %) patients with an end-to-end anastomosis versus 58 (21 %) patients with an end-to-side anastomosis (
p
= 0.50). A higher incidence in anastomotic strictures was seen in end-to-end anastomoses (48 (43 %)) compared with end-to-side anastomoses (89 (32 %);
p
= 0.04). Moreover, a median of 11 (7–17) dilations was necessary in patients with a benign anastomotic stricture in the end-to-end group compared with four (2–8) dilations in patients with a benign anastomotic stricture in the end-to-end group (
p
< 0.036). After multivariate analysis, the difference in anastomotic leakage rates remained nonsignificant (
p
= 0.74), whereas anastomotic stricture rate and number of dilations were higher in the end-to-end group (
p
= 0.03 and
p
= 0.01, respectively).
Conclusion
The technique of anastomosis is not significantly related to anastomotic leakage rate. However, patients with end-to-end anastomoses develop postoperative strictures more frequently, requiring a higher number of dilations compared to end-to-side anastomoses.</description><identifier>ISSN: 1091-255X</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1007/s11605-013-2159-8</identifier><identifier>PMID: 23400509</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Aged ; Anastomosis, Surgical - methods ; Anastomotic Leak - epidemiology ; Chi-Square Distribution ; Esophageal Neoplasms - surgery ; Esophageal Stenosis - epidemiology ; Esophagectomy - methods ; Esophagus ; Female ; Gastroenterology ; Humans ; Incidence ; Linear Models ; Male ; Medical referrals ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Multivariate analysis ; Netherlands - epidemiology ; Original Article ; Postoperative Complications - epidemiology ; Statistics, Nonparametric ; Surgeons ; Surgery ; Surgical anastomosis ; Treatment Outcome</subject><ispartof>Journal of gastrointestinal surgery, 2013-05, Vol.17 (5), p.872-876</ispartof><rights>The Society for Surgery of the Alimentary Tract 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-197f27fd9b15a60e075988364634c140564e2df963cc981399dc588639c83dc63</citedby><cites>FETCH-LOGICAL-c372t-197f27fd9b15a60e075988364634c140564e2df963cc981399dc588639c83dc63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11605-013-2159-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11605-013-2159-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23400509$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Haverkamp, Leonie</creatorcontrib><creatorcontrib>van der Sluis, Pieter C.</creatorcontrib><creatorcontrib>Verhage, Roy J. J.</creatorcontrib><creatorcontrib>Siersema, Peter D.</creatorcontrib><creatorcontrib>Ruurda, Jelle P.</creatorcontrib><creatorcontrib>van Hillegersberg, Richard</creatorcontrib><title>End-to-End Cervical Esophagogastric Anastomoses Are Associated with a Higher Number of Strictures Compared with End-to-Side Anastomoses</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><addtitle>J Gastrointest Surg</addtitle><description>Background
Leakage and benign strictures occur frequently after esophagectomy. The objective of this study was to analyze the outcome of hand-sewn end-to-end versus end-to-side cervical esophagogastric anastomoses.
Methods
A series of 390 consecutive patients who underwent esophagectomy with gastric conduit reconstruction was analyzed.
Results
The end-to-end technique was performed in 112 (29 %) patients and the end-to-side in 278 (71 %) patients. Anastomotic leakage occurred in 20 (18 %) patients with an end-to-end anastomosis versus 58 (21 %) patients with an end-to-side anastomosis (
p
= 0.50). A higher incidence in anastomotic strictures was seen in end-to-end anastomoses (48 (43 %)) compared with end-to-side anastomoses (89 (32 %);
p
= 0.04). Moreover, a median of 11 (7–17) dilations was necessary in patients with a benign anastomotic stricture in the end-to-end group compared with four (2–8) dilations in patients with a benign anastomotic stricture in the end-to-end group (
p
< 0.036). After multivariate analysis, the difference in anastomotic leakage rates remained nonsignificant (
p
= 0.74), whereas anastomotic stricture rate and number of dilations were higher in the end-to-end group (
p
= 0.03 and
p
= 0.01, respectively).
Conclusion
The technique of anastomosis is not significantly related to anastomotic leakage rate. However, patients with end-to-end anastomoses develop postoperative strictures more frequently, requiring a higher number of dilations compared to end-to-side anastomoses.</description><subject>Aged</subject><subject>Anastomosis, Surgical - methods</subject><subject>Anastomotic Leak - epidemiology</subject><subject>Chi-Square Distribution</subject><subject>Esophageal Neoplasms - surgery</subject><subject>Esophageal Stenosis - epidemiology</subject><subject>Esophagectomy - methods</subject><subject>Esophagus</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Linear Models</subject><subject>Male</subject><subject>Medical referrals</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Netherlands - epidemiology</subject><subject>Original Article</subject><subject>Postoperative Complications - epidemiology</subject><subject>Statistics, Nonparametric</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surgical anastomosis</subject><subject>Treatment Outcome</subject><issn>1091-255X</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kUFrGzEQhUVJaNK0P6CXIsilF7Uz0korHY1x60JoD0kgNyFrtfYG78qRdhP6C_q3K2OnhEBPb2C-92bgEfIR4QsC1F8zogLJAAXjKA3Tb8g56lqwSnF1UmYwyLiUd2fkXc73AFgD6rfkjIsKQII5J38WQ8PGyIrQeUiPnXdbushxt3HruHZ5TJ2ns6EMsY85ZDpLgc5yjr5zY2joUzduqKPLbr0Jif6c-lWR2NLrvXGcUnHMY79z6Zk93rvumvAy9z05bd02hw9HvSC33xY38yW7-vX9x3x2xbyo-cjQ1C2v28asUDoFAWpptBaqUqLyWIFUVeBNa5Tw3mgUxjReaq2E8Vo0XokL8vmQu0vxYQp5tH2Xfdhu3RDilC0KrrDiRkNBL1-h93FKQ_luT0nk3EBdKDxQPsWcU2jtLnW9S78tgt23ZA8t2dKS3bdkdfF8OiZPqz40_xzPtRSAH4BcVsM6pBen_5v6F86ZnBs</recordid><startdate>20130501</startdate><enddate>20130501</enddate><creator>Haverkamp, Leonie</creator><creator>van der Sluis, Pieter C.</creator><creator>Verhage, Roy J. J.</creator><creator>Siersema, Peter D.</creator><creator>Ruurda, Jelle P.</creator><creator>van Hillegersberg, Richard</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20130501</creationdate><title>End-to-End Cervical Esophagogastric Anastomoses Are Associated with a Higher Number of Strictures Compared with End-to-Side Anastomoses</title><author>Haverkamp, Leonie ; van der Sluis, Pieter C. ; Verhage, Roy J. J. ; Siersema, Peter D. ; Ruurda, Jelle P. ; van Hillegersberg, Richard</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-197f27fd9b15a60e075988364634c140564e2df963cc981399dc588639c83dc63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Anastomosis, Surgical - methods</topic><topic>Anastomotic Leak - epidemiology</topic><topic>Chi-Square Distribution</topic><topic>Esophageal Neoplasms - surgery</topic><topic>Esophageal Stenosis - epidemiology</topic><topic>Esophagectomy - methods</topic><topic>Esophagus</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Linear Models</topic><topic>Male</topic><topic>Medical referrals</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Netherlands - epidemiology</topic><topic>Original Article</topic><topic>Postoperative Complications - epidemiology</topic><topic>Statistics, Nonparametric</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Surgical anastomosis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Haverkamp, Leonie</creatorcontrib><creatorcontrib>van der Sluis, Pieter C.</creatorcontrib><creatorcontrib>Verhage, Roy J. J.</creatorcontrib><creatorcontrib>Siersema, Peter D.</creatorcontrib><creatorcontrib>Ruurda, Jelle P.</creatorcontrib><creatorcontrib>van Hillegersberg, Richard</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastrointestinal surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Haverkamp, Leonie</au><au>van der Sluis, Pieter C.</au><au>Verhage, Roy J. J.</au><au>Siersema, Peter D.</au><au>Ruurda, Jelle P.</au><au>van Hillegersberg, Richard</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>End-to-End Cervical Esophagogastric Anastomoses Are Associated with a Higher Number of Strictures Compared with End-to-Side Anastomoses</atitle><jtitle>Journal of gastrointestinal surgery</jtitle><stitle>J Gastrointest Surg</stitle><addtitle>J Gastrointest Surg</addtitle><date>2013-05-01</date><risdate>2013</risdate><volume>17</volume><issue>5</issue><spage>872</spage><epage>876</epage><pages>872-876</pages><issn>1091-255X</issn><eissn>1873-4626</eissn><abstract>Background
Leakage and benign strictures occur frequently after esophagectomy. The objective of this study was to analyze the outcome of hand-sewn end-to-end versus end-to-side cervical esophagogastric anastomoses.
Methods
A series of 390 consecutive patients who underwent esophagectomy with gastric conduit reconstruction was analyzed.
Results
The end-to-end technique was performed in 112 (29 %) patients and the end-to-side in 278 (71 %) patients. Anastomotic leakage occurred in 20 (18 %) patients with an end-to-end anastomosis versus 58 (21 %) patients with an end-to-side anastomosis (
p
= 0.50). A higher incidence in anastomotic strictures was seen in end-to-end anastomoses (48 (43 %)) compared with end-to-side anastomoses (89 (32 %);
p
= 0.04). Moreover, a median of 11 (7–17) dilations was necessary in patients with a benign anastomotic stricture in the end-to-end group compared with four (2–8) dilations in patients with a benign anastomotic stricture in the end-to-end group (
p
< 0.036). After multivariate analysis, the difference in anastomotic leakage rates remained nonsignificant (
p
= 0.74), whereas anastomotic stricture rate and number of dilations were higher in the end-to-end group (
p
= 0.03 and
p
= 0.01, respectively).
Conclusion
The technique of anastomosis is not significantly related to anastomotic leakage rate. However, patients with end-to-end anastomoses develop postoperative strictures more frequently, requiring a higher number of dilations compared to end-to-side anastomoses.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>23400509</pmid><doi>10.1007/s11605-013-2159-8</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Journal of gastrointestinal surgery, 2013-05, Vol.17 (5), p.872-876 |
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| language | eng |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Aged Anastomosis, Surgical - methods Anastomotic Leak - epidemiology Chi-Square Distribution Esophageal Neoplasms - surgery Esophageal Stenosis - epidemiology Esophagectomy - methods Esophagus Female Gastroenterology Humans Incidence Linear Models Male Medical referrals Medicine Medicine & Public Health Middle Aged Mortality Multivariate analysis Netherlands - epidemiology Original Article Postoperative Complications - epidemiology Statistics, Nonparametric Surgeons Surgery Surgical anastomosis Treatment Outcome |
| title | End-to-End Cervical Esophagogastric Anastomoses Are Associated with a Higher Number of Strictures Compared with End-to-Side Anastomoses |
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