An analysis of the risk factors of anastomotic stricture after esophagectomy

Koji Tanaka, Tomoki Makino, Makoto Yamasaki, Takahiko Nishigaki, Yasuhiro Miyazaki, Tsuyoshi Takahashi, Yukinori Kurokawa, Kiyokazu Nakajima, Shuji Takiguchi, Masaki Mori, Yuichiro Doki

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Abstract

Purpose: Anastomotic stricture after esophagectomy is a major cause of long-term morbidity and a poor quality of life. The aim of this study was to identify the risk factors for the development of anastomotic stricture after esophagectomy. Methods: The study subjects were 213 patients who underwent esophagectomy for squamous cell carcinoma of the esophagus between 2012 and 2014. Anastomotic stricture was defined as stenosis at the site of anastomosis that required endoscopic dilation. Refractory stricture was defined as that requiring more than four sessions of dilations. Univariate and multivariate logistic regression analyses were used to identify the potential risk factors for the development of anastomotic stricture. Results: In this retrospective study, 29 patients (13.6%) developed anastomotic stricture within a median period of 108 postoperative days and required a median of 2 dilations. Tumors located in the upper part of the esophagus (p = 0.004), the presence of cardiovascular disease (p = 0.024) and anastomotic leakage (p = 0.002) were identified as independent risk factors for the development of anastomotic stricture. The time to the diagnosis of refractory stricture (85 ± 33 days) was significantly shorter than that of non-refractory stricture (171 ± 22 days, p = 0.038). Conclusions: Patients with squamous cell carcinoma in the upper esophagus with cardiovascular disease who develop postoperative anastomotic leakage should be carefully monitored to prevent the development of benign anastomotic stricture.

Original languageEnglish
Pages (from-to)449-454
Number of pages6
JournalSurgery today
Volume48
Issue number4
DOIs
Publication statusPublished - Apr 1 2018
Externally publishedYes

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All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Tanaka, K., Makino, T., Yamasaki, M., Nishigaki, T., Miyazaki, Y., Takahashi, T., ... Doki, Y. (2018). An analysis of the risk factors of anastomotic stricture after esophagectomy. Surgery today, 48(4), 449-454. https://doi.org/10.1007/s00595-017-1608-5