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Related Concept Videos

Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

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Related Experiment Video

Updated: Mar 12, 2026

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
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Does Routine Endoscopy or Contrast Swallow Study After Esophagectomy and Gastric Tube Reconstruction Change Patient

N Nederlof1, J de Jonge1, T de Vringer1

  • 1Department of Surgery, Erasmus MC University Medical Centre Rotterdam, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|November 16, 2016
PubMed
Summary

Routine contrast swallow studies and endoscopy lack diagnostic value for detecting anastomotic leakage after esophagectomy in patients without symptoms. These tests are not beneficial when clinical suspicion is absent.

Keywords:
AnastomosisComplicationContrast swallowEndoscopyEsophagectomyLeakage

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Diagnostic Imaging

Background:

  • Anastomotic leakage is a critical complication following esophagectomy.
  • Early and accurate detection of anastomotic dehiscence is crucial for patient outcomes.

Purpose of the Study:

  • To evaluate the diagnostic and predictive accuracy of routine contrast swallow studies and endoscopy.
  • To determine the utility of these investigations in detecting anastomotic dehiscence post-esophagectomy.

Main Methods:

  • Retrospective analysis of patients undergoing contrast swallow and/or endoscopy within 7 days post-esophagectomy for cancer.
  • Inclusion criteria: January 2005 to December 2009 from an institutional database.

Main Results:

  • Endoscopy sensitivity: 56%, specificity: 41%, PPV: 8%, NPV: 95% for leakage requiring intervention.
  • Contrast swallow study sensitivity: 20%, specificity: 20%, PPV: 3%, NPV: 97% for leakage requiring intervention.
  • Both methods showed limited diagnostic value, particularly in asymptomatic patients.

Conclusions:

  • Routine contrast swallow studies and endoscopy offer no benefit in patients without clinical suspicion of anastomotic leakage.
  • Clinical assessment remains paramount in the diagnosis of post-esophagectomy complications.