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Updated: Feb 18, 2026
An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
Pilot study on preventing anastomotic leakage in stapled gastroesophageal anastomosis
Shijie Zhang1, Weiming Huang1, Xiangzheng Liu1
1Department of Thoracic Surgery, Peking University First Hospital, Beijing, China.
Background:
This study explored how to improve the surgical technique to reduce or avoid anastomotic leakage.
Methods:
From January 2012 to December 2016, 101 consecutive patients with cancer of the esophagus or gastroesophageal junction underwent stapled gastroesophageal anastomosis. The procedure included creating a tube-type stomach, fixing an inserted anvil, inspecting mucosa-to-mucosa alignment in the lumen under direct vision after firing the stapler, and, if found, manually repairing a rupture of the mucous membrane of the anastomosis.
Results:
A rupture of the mucous membrane of the anastomosis was found in four out of the 101 patients and manually repaired. No postsurgical anastomotic leakage occurred. All patients recovered well and the average postoperative stay was 10.4 days. There was no mortality within 30 days after surgery.
Conclusion:
It is critical to inspect the integrality of the luminal mucous membrane of the anastomosis under direct vision in order to prevent anastomotic leakage in surgical resection of esophageal and gastroesophageal junction malignancies.
