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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 t...

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Autores principales: Li, Xiao‐Kun, Xu, Yang, Cong, Zhuang‐Zhuang, Luo, Jing, Zhou, Hai, Ji, Sai‐Guang, Diao, Yi‐Fei, Wu, Wen‐Jie, Qiang, Yong, Qian, Jian‐Jun, Shen, Yi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529547/
https://www.ncbi.nlm.nih.gov/pubmed/32833352
http://dx.doi.org/10.1111/1759-7714.13630
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author Li, Xiao‐Kun
Xu, Yang
Cong, Zhuang‐Zhuang
Luo, Jing
Zhou, Hai
Ji, Sai‐Guang
Diao, Yi‐Fei
Wu, Wen‐Jie
Qiang, Yong
Qian, Jian‐Jun
Shen, Yi
author_facet Li, Xiao‐Kun
Xu, Yang
Cong, Zhuang‐Zhuang
Luo, Jing
Zhou, Hai
Ji, Sai‐Guang
Diao, Yi‐Fei
Wu, Wen‐Jie
Qiang, Yong
Qian, Jian‐Jun
Shen, Yi
author_sort Li, Xiao‐Kun
collection PubMed
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.
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spelling pubmed-75295472020-10-05 Modified Collard versus end‐to‐side hand‐sewn anastomosis for cervical anastomosis after McKeown esophagectomy Li, Xiao‐Kun Xu, Yang Cong, Zhuang‐Zhuang Luo, Jing Zhou, Hai Ji, Sai‐Guang Diao, Yi‐Fei Wu, Wen‐Jie Qiang, Yong Qian, Jian‐Jun Shen, Yi Thorac Cancer Original Articles 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. John Wiley & Sons Australia, Ltd 2020-08-24 2020-10 /pmc/articles/PMC7529547/ /pubmed/32833352 http://dx.doi.org/10.1111/1759-7714.13630 Text en © 2020 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Li, Xiao‐Kun
Xu, Yang
Cong, Zhuang‐Zhuang
Luo, Jing
Zhou, Hai
Ji, Sai‐Guang
Diao, Yi‐Fei
Wu, Wen‐Jie
Qiang, Yong
Qian, Jian‐Jun
Shen, Yi
Modified Collard versus end‐to‐side hand‐sewn anastomosis for cervical anastomosis after McKeown esophagectomy
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 Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529547/
https://www.ncbi.nlm.nih.gov/pubmed/32833352
http://dx.doi.org/10.1111/1759-7714.13630
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