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Authors Zhou D, Liu QX, Deng XF, Zheng H, Lu X, Dai JG, Jiang L
Received 9 July 2017
Accepted for publication 20 December 2017
Published 7 February 2018 Volume 2018:10 Pages 257—263
DOI https://doi.org/10.2147/CMAR.S145917
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Akshita Wason
Peer reviewer comments 2
Editor who approved publication: Professor Nakshatri
Purpose: Anastomotic leakage is the most feared postoperative complication after
esophagectomy. Omentoplasty, wrapping the omentum around the alimentary tract
anastomosis, is thought to decrease the anastomotic leakage rate. The purpose
of this clinical study is to investigate the use of omentoplasty to reinforce
cervical esophagogastrostomy after minimally invasive esophagectomy (MIE).
Patients and
methods: In this retrospective study, the
data of 160 consecutive patients who underwent cervical esophagogastrostomy
after MIE between September 2012 and May 2015 were analyzed, 87 who underwent
omentoplasty (group A) and 73 who did not undergo omentoplasty (group B). The
primary outcome was the incidence of anastomotic leakage and anastomotic
strictures after the operation. Secondary outcomes were other complications and
mortality rate. Univariate and multivariate analysis of variables associated
with an increased risk for anastomotic leak was performed.
Results: The median age was 61 years (range, 37–82 years). The
anastomotic leakage rates were 4.6% (4/87) in group A and 15.1% (11/73) in
group B (P = 0.023). There was no
statistical significance in anastomotic stricture rates between group A (6.9%)
and group B (9.6%; P = 0.535). No
difference was noted in other complications between the groups. There was a
trend toward lower leak-associated mortality rates for group A (0%) compared
with that for group B (4.1%).
Conclusion: Cervical esophagogastrostomy with omentoplasty is more effective than
esophagogastrostomy without omentoplasty for the prevention of anastomotic
leakage in MIE with cervical anastomosis. Omentoplasty could be used as an
adjunct technique to reduce the incidence of anastomotic leakage in cervical
esophagogastrostomy following MIE.
Keywords: omentoplasty, cervical esophagogastrostomy, minimally invasive
esophagectomy, anastomosis leakage, stricture