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Research ArticleClinical Studies

Impact of Arteriosclerosis on Reconstruction-related Complications After Esophagectomy and Usefulness of Tailor-made Reconstruction Technique

TAKAHISA YAMAGUCHI, KOICHI OKAMOTO, HIROTO SAITO, MARI SHIMADA, TOSHIKATSU TSUJI, HIDEKI MORIYAMA, JUN KINOSHITA, ITASU NINOMIYA and NORIYUKI INAKI
Anticancer Research April 2024, 44 (4) 1719-1726; DOI: https://doi.org/10.21873/anticanres.16971
TAKAHISA YAMAGUCHI
1Department of Gastrointestinal Surgery, Kanazawa University, Kanazawa, Japan;
2Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan;
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KOICHI OKAMOTO
3Department of General and Digestive Surgery, Kanazawa Medical University Hospital, Kahoku, Japan;
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  • For correspondence: kokamoto@kanazawa-med.ac.jp
HIROTO SAITO
1Department of Gastrointestinal Surgery, Kanazawa University, Kanazawa, Japan;
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MARI SHIMADA
1Department of Gastrointestinal Surgery, Kanazawa University, Kanazawa, Japan;
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TOSHIKATSU TSUJI
1Department of Gastrointestinal Surgery, Kanazawa University, Kanazawa, Japan;
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HIDEKI MORIYAMA
1Department of Gastrointestinal Surgery, Kanazawa University, Kanazawa, Japan;
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JUN KINOSHITA
1Department of Gastrointestinal Surgery, Kanazawa University, Kanazawa, Japan;
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ITASU NINOMIYA
4Department of Surgery, Fukui Prefectural Hospital, Yotsui, Japan
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NORIYUKI INAKI
1Department of Gastrointestinal Surgery, Kanazawa University, Kanazawa, Japan;
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Abstract

Background/Aim: Anastomotic leakage is one of the most common and serious postoperative complications following esophagectomy. This study analyzed the effect of risk factors, such as the degree of arteriosclerosis, comorbidities, and patient characteristics on the incidence of reconstruction-related complications including anastomotic leakage. Furthermore, the usefulness of tailor-made reconstruction methods was clarified using wide gastric conduit. Patients and Methods: Patients who underwent esophagectomy with a gastric conduit for esophageal cancer between 2011 and 2018 were enrolled. In the initial group that underwent esophagectomy between August 2011 and February 2016, gastrointestinal reconstruction was performed using a narrow gastric conduit. In the latter group, reconstruction using subtotal gastric conduit was selected for high-risk patients between March 2016 and March 2018. Postoperative complications including reconstruction-related complications were assessed. Results: The occurrence of anastomotic leakage was significantly associated with the patient’s risk in the initial group. The rates of anastomotic leakage and reconstruction-related complications were significantly lower in the latter group than in the initial group (3.2% vs. 23.0%, p=0.001; 27.0% vs. 44.3%, p=0.044). The incidence of all complications was significantly lower in the latter group than in the initial group (28.6% vs. 59.0%, p=0.001). The change in bodyweight loss one year after the operation was significantly lower in the latter group than in the initial group (p=0.042). Conclusion: Tailor-made reconstruction using wide gastric conduit for high-risk cases of esophageal cancer could reduce the occurrence of anastomotic leakage and promote a better quality of life after surgery.

Key Words:
  • Anastomotic leakage
  • complication
  • esophageal cancer
  • arteriosclerosis
  • esophagectomy
  • Received January 6, 2024.
  • Revision received January 30, 2024.
  • Accepted January 31, 2024.
  • Copyright © 2024 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 44 (4)
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April 2024
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Impact of Arteriosclerosis on Reconstruction-related Complications After Esophagectomy and Usefulness of Tailor-made Reconstruction Technique
TAKAHISA YAMAGUCHI, KOICHI OKAMOTO, HIROTO SAITO, MARI SHIMADA, TOSHIKATSU TSUJI, HIDEKI MORIYAMA, JUN KINOSHITA, ITASU NINOMIYA, NORIYUKI INAKI
Anticancer Research Apr 2024, 44 (4) 1719-1726; DOI: 10.21873/anticanres.16971

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Impact of Arteriosclerosis on Reconstruction-related Complications After Esophagectomy and Usefulness of Tailor-made Reconstruction Technique
TAKAHISA YAMAGUCHI, KOICHI OKAMOTO, HIROTO SAITO, MARI SHIMADA, TOSHIKATSU TSUJI, HIDEKI MORIYAMA, JUN KINOSHITA, ITASU NINOMIYA, NORIYUKI INAKI
Anticancer Research Apr 2024, 44 (4) 1719-1726; DOI: 10.21873/anticanres.16971
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Keywords

  • Anastomotic leakage
  • complication
  • Esophageal cancer
  • arteriosclerosis
  • esophagectomy
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