Comparison of cervical anastomotic leak and stenosis after oesophagectomy for carcinoma according to the interval of the stomach ischaemic conditioning

Authors	PROCHÁZKA Vladimír MAREK Filip KUNOVSKÝ Lumír SVATOŇ Roman GROLICH Tomáš MORAVČÍK Petr FARKAŠOVÁ Martina KALA Zdeněk
Year of publication	2018
Type	Article in Periodical
Magazine / Source	ANNALS OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND
MU Faculty or unit	Faculty of Medicine
Citation
Doi	http://dx.doi.org/10.1308/rcsann.2018.0066
Keywords	Anastomotic leak; Anastomotic stenosis; Oesophageal carcinoma; Minimally invasive oesophagectomy; Stomach ischaemic conditioning
Description	BACKGROUND Stomach preparation by ischaemic conditioning prior to oesophageal resection represents a potential method of reducing the risk of anastomotic complications. This study compares the results of the anastomotic complications of cervical anastomosis after oesophagectomy with a short interval after ischaemic conditioning (group S) and a long interval (group L). METHODS Subjects undergoing oesophagectomy for carcinoma after ischaemic conditioning were divided into two groups. Group S had a median interval between ischaemic conditioning and resection of 20 days, while for group L the median interval was 49 days. Anastomotic leak and anastomotic stenosis in relation to the interval between ischaemic conditioning and actual resection were followed. RESULTS After ischaemic conditioning, 33 subjects in total underwent surgery for carcinoma; 19 subjects in group S and 14 subjects in group L. Anastomotic leak incidence was comparable in both groups. Anastomotic stenosis occurred in 21% of cases in group S and 7% of cases in group L (not statistically significant). CONCLUSION A long interval between ischaemic conditioning and oesophagectomy does not adversely affect the postoperative complications. A lower incidence of anastomosis stenoses was found in subjects with a longer interval, however, given the size of our sample, the statistical significance was not demonstrated. Both groups seem comparable in surgical procedure course and postoperative complications.