Open AccessComparison of the modified Collard and hand‐sewn anastomosis for cervical esophagogastric anastomosis after esophagectomy in esophageal cancer patients: A propensity score‐matched analysis
Author(s) -
Sugimura Keijiro,
Miyata Hiroshi,
Matsunaga Tomoyuki,
Asukai Kei,
Yanagimoto Yoshitomo,
Takahashi Yusuke,
Tomokuni Akira,
Yamamoto Kazuyoshi,
Hirofumi Akita,
Nishimura Junichi,
Motoori Masaaki,
Wada Hiroshi,
Takahashi Hidenori,
Yasui Masayoshi,
Omori Takeshi,
Ohue Masayuki,
Yano Masahiko
Publication year - 2019
Publication title -
annals of gastroenterological surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.308
H-Index - 15
ISSN - 2475-0328
DOI - 10.1002/ags3.12220
Subject(s) - anastomosis , esophagectomy , medicine , esophageal cancer , propensity score matching , stenosis , esophagus , surgery , cancer
Background Several studies have reported that modified Collard anastomosis is useful for cervical anastomosis after esophagectomy for thoracic esophageal cancer. However, no large‐scale study has confirmed the efficacy of the modified Collard anastomosis. Methods Between 2008 and 2016, 398 consecutive esophageal cancer patients who underwent esophagectomy and cervical anastomosis were enrolled in this study. Patients with a short remnant cervical esophagus were excluded. We investigated the utility of the modified Collard anastomosis by comparing the results of postoperative complications using a propensity score‐matched analysis between the hand‐sewn method ( HS ) and the modified Collard anastomosis ( MC ) for esophagogastric anastomosis of the neck after esophagectomy in thoracic esophageal cancer patients. Results Of the 398 patients, 127 were included in the MC group and 127 were included in the HS group after propensity score matching. Clinical characteristics did not differ between the two groups. Frequency of anastomotic leakage tended to be lower in the MC group than in the HS group (3% vs. 7%, P = 0.127). Frequency of anastomotic stenosis was significantly lower in the MC group than in the HS group (13% vs. 59%, P < 0.001). Multivariate logic analysis showed that anastomotic technique ( HS ) and performance status were independent factors associated with anastomotic stenosis (odds ratio, 12.24 and 2.52; P ‐value <0.001 and 0.047, respectively). Conclusion In cervical esophagogastric anastomosis after esophagectomy, the modified Collard anastomosis is more suitable than hand‐sewn anastomosis in terms of reducing the frequency of anastomotic stenosis.