Baseball bat-like gastric tube for end-to-side oesophageal-gastric anastomosis decreased risks of anastomotic leakage after oesophagectomy for oesophageal cancer: A retrospective propensity score matched comparative study with 613 patients.

PURPOSE

To investigate the relationship between baseball bat-like gastric tubes for end-to-side oesophageal-gastric anastomosis and occurrence of anastomotic leakage after oesophagectomy for oesophageal cancer.

METHODS

From July 2019 to June 2021, 613 patients with bat-like or narrow gastric tubes for end-to-side oesophageal-gastric anastomosis in oesophagectomy were retrospectively enrolled, in which 120 patients had narrow gastric tubes and 493 had bat-like gastric tubes. Clinical data including baseline characteristics, in-hospital variables and follow-up outcomes were collected.

RESULTS

Higher occurrence of anastomotic leak was observed in the narrow group in the unmatched cohort (14.2%, 17/120 vs. 7.3%, 36/493; P = 0.016) or the matched cohort after Propensity Score Matching (PSM) analysis (14.2%, 17/120 vs. 7.5%, 27/360, P = 0.028) when compared to the bat-like group; Multivariable analysis for risk factors of postoperative anastomotic leak in the unmatched cohort showed that the use of bat-like gastric tube was an independent protective factor (OR: 0.502, 95% CI: 0.270-0.935, P = 0.030).

CONCLUSIONS

Bat-like gastric tube can be used for end-to-side oesophageal-gastric anastomosis in oesophagectomy. This technique by improving blood supply to the area distal to the anastomosis decreased the incidence of anastomotic leak.