title: Post-esophagectomy anastomotic leaks. The role of the anastomotic location.
abstract: OBJECTIVE
  Esophageal anastomotic leaks are associated with significant morbidity and mortality. The purpose of this study was to retrospectively assess the role of the anastomotic positioning (thoracic or cervical) on the incindence of the anastomotic leak and its severity.
  
  
  METHODS
  In the period 2002-07, we have performed extended esophagectomy with a curative-intent in 63 patients with esophageal cancer. The clinical outcome of the 46 patients where a cervical anastomosis was performed (Group A) has been compared with that of the 17 with thoracic anastomosis (Group B), in terms of leak incidence, pattern of healing, morbidity, and mortality.
  
  
  RESULTS
  Leaks occurred in 11% patients of the in group A and in 8% of the group B. When the dehiscence has occurred in the cervical region 1/4th of patients died before the 30th post-operative day compared to the 3/5th of those where the leak occurred at the level of the thorax.
  
  
  CONCLUSIONS
  On the basis of our findings we suggest the adopt the cervical anastomosis due to lower mortality rate related when leaks occur.
authors.forename: Stefano
authors.initials: S
authors.lastname: Cafarotti
authors.forename: Alfredo
authors.initials: A
authors.lastname: Cesario
authors.forename: Venanzio
authors.initials: V
authors.lastname: Porziella
authors.forename: Giovanni
authors.initials: G
authors.lastname: Leuzzi
authors.forename: Maria Letizia
authors.initials: ML
authors.lastname: Vita
authors.forename: Elisa
authors.initials: E
authors.lastname: Meacci
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Congedo
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Granone
mesh_terms: D000714:Anastomosis, Surgical; D057868:Anastomotic Leak; D004938:Esophageal Neoplasms / Q000601:surgery; D016629:Esophagectomy; D006801:Humans; D016896:Treatment Outcome