ArticleAnnals of surgical oncology2025
Risk Factors for Benign Anastomotic Stenosis After Esophagectomy for Cancer.
Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Postoperative pulmonary complications after esophagectomy: risk factors and prediction model.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2026Article
- Late-onset esophagogastric anastomotic fistula managed without continuous fasting: a case report.Journal of surgical case reports · 2025Article
- Response to Comment on "Letter to the Editor".Annals of surgical oncology · 2025Article
- Comment on "Risk Factors for Benign Anastomotic Stenosis After Esophagectomy for Cancer".Annals of surgical oncology · 2025Article
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7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundBenign stenosis frequently occurs after esophagectomy, causing dysphagia, eating problems, and diminished quality of life. This study aimed to identify risk factors for benign anastomotic stenosis after esophagectomy for cancer.
methodsThis retrospective cohort study analyzed patients who underwent esophagectomy at Amsterdam UMC from 2012 until 2022. Intrathoracic and cervical anastomoses were examined separately. Benign anastomotic stenosis was defined as stenosis at the anastomosis causing dysphagia (Ogilvie score ≥2) and requiring at least one endoscopic dilation. Predictive factors were identified using logistic regression.
resultsThe study enrolled 902 patients: 605 with intrathoracic and 297 with cervical anastomosis. Of these cases, 91.1 % were a minimally invasive esophagectomy. Stenosis occurred in 18.4 % of the intrathoracic cases and 49.8 % of the cervical cases (p < 0.001). The patients required medians of 4 and 7 dilations, respectively (p = 0.001). The median time to stenosis was 99 days for the intrathor days for the cervical anastomoses (p = 0.001). Intrathoracic stenosis was independently associated with anastomotic leakage (odds ratio [OR], 2.034; 95 % confidence interval [CI], 1.116-3.708). For the patients without leakage, a 2 mm versus a 25 mm circular stapler reduced stenosis risk (OR, 0.486; 95 % CI, 0.294-0.803), whereas use of immunosuppressants (OR, 3.492; 95 % CI, 1.186-10.279]) and chronic pulmonary disease (OR, 2.717; 95 % CI, 1.293-5.707) increased it. For cervical anastomoses, hand-sewn end-to-side anastomosis was protective (OR, 0.454; 95 % CI, 0.234-0.879).
conclusionsThe key risk factors for intrathoracic benign anastomotic stenosis are anastomotic leakage, smaller circular stapler size, use of immunosuppressants, and chronic pulmonary disease. For cervical anastomoses, the hand-sewn end-to side technique is protective compared with the end-to-end technique, whereas use of immunosuppressants and chronic pulmonary disease increases the risk.
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