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Updated: May 7, 2026
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An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
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Anastomotic Failure Is Not Affected by Anastomotic Technique in Minimally Invasive Two-Stage Oesophagectomy
ANZ Journal of Surgery
|May 6, 2026
Summary
Anastomotic technique choice did not impact complications after minimally invasive oesophagectomy. Patient factors like recent smoking and heart disease independently predicted anastomotic issues in oesophageal cancer surgery.
Area of Science:
- Gastrointestinal Surgery
- Surgical Oncology
- Minimally Invasive Procedures
Background:
- Anastomotic technique choice in minimally invasive oesophagectomy (MIO) may affect patient outcomes.
- This study investigates circular stapled (CS) versus linear stapled (LS) anastomosis in MIO for oesophageal cancer.
Purpose of the Study:
- To determine if CS or LS anastomosis is associated with higher rates of anastomotic complications following MIO.
- To identify risk factors for anastomotic leak and stricture after MIO.
Main Methods:
- Retrospective cohort study of 245 patients undergoing two-stage MIO with intrathoracic anastomosis.
- Primary outcomes: anastomotic leak and stricture formation.
- Secondary outcomes: postoperative complications, survival; multivariate logistic regression used.
Main Results:
- Leak rates were 13.0% for CS and 8.3% for LS (p=0.271). Stricture rates were 17.4% for CS and 16.6% for LS (p=0.817).
- No significant difference in leak or stricture rates between CS and LS anastomosis.
- Recent smoking and ischaemic heart disease were independent predictors of anastomotic complications.
Conclusions:
- Anastomotic technique (CS vs. LS) is not significantly associated with anastomotic leak or stricture in MIO.
- Modifiable patient factors, such as recent smoking and ischaemic heart disease, are key predictors of anastomotic complications.
