Modified Collard versus end‐to‐side hand‐sewn anastomosis for cervical anastomosis after McKeown esophagectomy
Background According to previously published studies, esophagectomy with modified Collard anastomosis has been reported to have low incidences of anastomotic leak and stricture. However, the optional anastomotic method after esophagectomy is still controversial. We conducted this study to compare th...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-10-01
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| Series: | Thoracic Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/1759-7714.13630 |
| _version_ | 1818528161791475712 |
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| author | Xiao‐Kun Li Yang Xu Zhuang‐Zhuang Cong Jing Luo Hai Zhou Sai‐Guang Ji Yi‐Fei Diao Wen‐Jie Wu Yong Qiang Jian‐Jun Qian Yi Shen |
| author_facet | Xiao‐Kun Li Yang Xu Zhuang‐Zhuang Cong Jing Luo Hai Zhou Sai‐Guang Ji Yi‐Fei Diao Wen‐Jie Wu Yong Qiang Jian‐Jun Qian Yi Shen |
| author_sort | Xiao‐Kun Li |
| collection | DOAJ |
| description | Background According to previously published studies, esophagectomy with modified Collard anastomosis has been reported to have low incidences of anastomotic leak and stricture. However, the optional anastomotic method after esophagectomy is still controversial. We conducted this study to compare the incidence of postoperative anastomotic stricture formation and dysphagia over three years after an esophagectomy with modified Collard anastomosis (MC) or end‐to‐side (ETS) hand‐sewn anastomosis. Meanwhile, the early postoperative anastomotic leakage and other complications, hospital stay and 30‐ and 90‐day mortality were also evaluated. Methods The clinical data of 905 patients undergoing McKeown esophagectomy were retrospectively reviewed. The rate of postoperative stricture formation after three years was demonstrated by stricture‐free survival which is the primary end‐point of this study. The incidence of dysphagia, first time of onset of stricture and number of dilatations were also recorded during follow‐up. Results The incidence of anastomotic leak tended to be higher in the MC group compared with that in the ETS group (13.0% vs. 8.7%, P = 0.064). The rates of anastomotic stricture in the MC group were significantly less than in the ETS group (P = 0.004). The number of dilatations in the MC group were significantly greater than those in the ETS group (2.34 vs. 2.46, P = 0.011). Conclusions A modified Collard cervical esophagogastric anastomosis was associated with lower rates of anastomotic stricture and dysphagia, compared with ETS hand‐sewn anastomosis. However, the modified Collard anastomosis is accompanied by an increased anastomotic leakage rate. |
| first_indexed | 2024-12-11T06:46:04Z |
| format | Article |
| id | doaj.art-3bb6cbdcd77d4bc89e758c44dbb1509f |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-12-11T06:46:04Z |
| publishDate | 2020-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-3bb6cbdcd77d4bc89e758c44dbb1509f2022-12-22T01:17:04ZengWileyThoracic Cancer1759-77061759-77142020-10-0111102909291510.1111/1759-7714.13630Modified Collard versus end‐to‐side hand‐sewn anastomosis for cervical anastomosis after McKeown esophagectomyXiao‐Kun Li0Yang Xu1Zhuang‐Zhuang Cong2Jing Luo3Hai Zhou4Sai‐Guang Ji5Yi‐Fei Diao6Wen‐Jie Wu7Yong Qiang8Jian‐Jun Qian9Yi Shen10Department of Cardiothoracic Surgery, Jingling Hospital, School of Medicine Southeast University Nanjing ChinaDepartment of Cardiothoracic Surgery, Jingling Hospital Medical School of Nanjing University Nanjing ChinaDepartment of Cardiothoracic Surgery, Jingling Hospital, School of Clinical Medicine Nanjing Medical University Nanjing ChinaDepartment of Cardiothoracic Surgery, Jingling Hospital, School of Clinical Medicine Nanjing Medical University Nanjing ChinaDepartment of Clinical Medicine, School of Medicine Southeast University Nanjing ChinaDepartment of Thoracic Surgery, Nanjing Second Hospital, School of Medicine Southeast University Nanjing ChinaDepartment of Cardiothoracic Surgery, Jingling Hospital, School of Clinical Medicine Nanjing Medical University Nanjing ChinaDepartment of Clinical Medicine, School of Medicine Southeast University Nanjing ChinaDepartment of Cardiothoracic Surgery, Jingling Hospital, School of Medicine Southeast University Nanjing ChinaDepartment of Cardiothoracic Surgery, Jingling Hospital, School of Medicine Southeast University Nanjing ChinaDepartment of Cardiothoracic Surgery, Jingling Hospital, School of Medicine Southeast University Nanjing ChinaBackground According to previously published studies, esophagectomy with modified Collard anastomosis has been reported to have low incidences of anastomotic leak and stricture. However, the optional anastomotic method after esophagectomy is still controversial. We conducted this study to compare the incidence of postoperative anastomotic stricture formation and dysphagia over three years after an esophagectomy with modified Collard anastomosis (MC) or end‐to‐side (ETS) hand‐sewn anastomosis. Meanwhile, the early postoperative anastomotic leakage and other complications, hospital stay and 30‐ and 90‐day mortality were also evaluated. Methods The clinical data of 905 patients undergoing McKeown esophagectomy were retrospectively reviewed. The rate of postoperative stricture formation after three years was demonstrated by stricture‐free survival which is the primary end‐point of this study. The incidence of dysphagia, first time of onset of stricture and number of dilatations were also recorded during follow‐up. Results The incidence of anastomotic leak tended to be higher in the MC group compared with that in the ETS group (13.0% vs. 8.7%, P = 0.064). The rates of anastomotic stricture in the MC group were significantly less than in the ETS group (P = 0.004). The number of dilatations in the MC group were significantly greater than those in the ETS group (2.34 vs. 2.46, P = 0.011). Conclusions A modified Collard cervical esophagogastric anastomosis was associated with lower rates of anastomotic stricture and dysphagia, compared with ETS hand‐sewn anastomosis. However, the modified Collard anastomosis is accompanied by an increased anastomotic leakage rate.https://doi.org/10.1111/1759-7714.13630Anastomotic leakageanastomotic strictureend‐to‐side hand‐sewn anastomosisesophagecotmymodified Collard anastomosis |
| spellingShingle | Xiao‐Kun Li Yang Xu Zhuang‐Zhuang Cong Jing Luo Hai Zhou Sai‐Guang Ji Yi‐Fei Diao Wen‐Jie Wu Yong Qiang Jian‐Jun Qian Yi Shen Modified Collard versus end‐to‐side hand‐sewn anastomosis for cervical anastomosis after McKeown esophagectomy Thoracic Cancer Anastomotic leakage anastomotic stricture end‐to‐side hand‐sewn anastomosis esophagecotmy modified Collard anastomosis |
| title | Modified Collard versus end‐to‐side hand‐sewn anastomosis for cervical anastomosis after McKeown esophagectomy |
| title_full | Modified Collard versus end‐to‐side hand‐sewn anastomosis for cervical anastomosis after McKeown esophagectomy |
| title_fullStr | Modified Collard versus end‐to‐side hand‐sewn anastomosis for cervical anastomosis after McKeown esophagectomy |
| title_full_unstemmed | Modified Collard versus end‐to‐side hand‐sewn anastomosis for cervical anastomosis after McKeown esophagectomy |
| title_short | Modified Collard versus end‐to‐side hand‐sewn anastomosis for cervical anastomosis after McKeown esophagectomy |
| title_sort | modified collard versus end to side hand sewn anastomosis for cervical anastomosis after mckeown esophagectomy |
| topic | Anastomotic leakage anastomotic stricture end‐to‐side hand‐sewn anastomosis esophagecotmy modified Collard anastomosis |
| url | https://doi.org/10.1111/1759-7714.13630 |
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