Incidence and Risk Factors for Anastomotic Stricture after Esophagectomy with Gastric Tube Reconstruction.

BACKGROUND/AIMS: The aim of this study was to investigate the incidence and risk factors for anastomotic stricture after esophagectomy with gastric tube reconstruction.

METHODOLOGY

A total of 150 consecutive patients with esophageal cancer who underwent esophagectomy with gastric tube reconstruction were analyzed in this study. Anastomotic stricture was de fined as disturbance of the passage of a standard endo scope, with no evidence of locoregional cancer recurrence. Cumulative incidence was calculated using the Kaplan-Meier method. A total of 38 clinicopathological variables were assessed to elucidate the risk factors by univariate and multivariate analyses.

RESULTS

Anastomotic stricture developed in 61 of 150 patients 41%). The cumulative incidences were 34.2% at 6 months, and 37.9% at 12 months. Fifty-seven patients (93%) developed anastomotic stricture within 12 months after esophagectomy. A low preoperative partial pressure of arterial oxygen (odds ratio, 2.23; 95% confidence interval, 1.10-4.55; p = 0.027) and the presence of postoperative complications of Grade 3 or higher (3.05; 1.04-9.00; p = 0.043) were identified as the independent risk factors.

CONCLUSIONS

The incidence of anastomotic stricture after esophagectomy was high. A modification of anastomotic procedure may be necessary for patients with a low preoperative partial pressure of arterial oxygen to prevent the development of stricture.