title: [Risk factors of benign anastomostic strictures after esophagectomy with cervical reconstruction].
abstract: OBJECTIVE
  To identify the risk factors of benign cervical anastomotic strictures after esophagectomy.
  
  
  METHODS
  Clinical data of 946 esophageal cancer patients undergoing esophagectomy with cervical anastomosis between 2003 and 2012 were analyzed retrospectively. Benign stricture was defined as dysphagia for which endoscopic dilation of the anastomosis was needed. Histologically proven malignant stricture was not regarded as benign stricture. χ(2) test and logistic regression model were used for univariate and multivariate analysis respectively.
  
  
  RESULTS
  A total of 146 patients(16.5%) developed benign stricture during follow-up. Univariate analysis showed that the patients with cardiovascular disease (P=0.001), diabetes mellitus(P=0.041), gastric tube reconstruction(P=0.050), end-to-end anastomosis (P=0.013), or postoperative anastomotic leakage(P=0.008) had higher stricture rate. Multivariate analysis revealed that cardiovascular disease(P=0.004), gastric tube reconstruction (P=0.026), end-to-end anastomosis(P=0.043), and postoperative anastomotic leakage(P=0.001) were independently predictive factors for development of benign stricture.
  
  
  CONCLUSIONS
  The benign cervical stricture rate after esophagetomy with cervical gastric anastomosis is quite high. In order to prevent benign stricture formation, end-to-end anastomosis should be avoid. Blood pressure should be controlled for those with cardiovascular disease. Endoscopic dilation in an earlier stage postoperatively should be considered for those who develop anastomotic leakage.
authors.affiliation: Department of Thoracic Surgery, Huai'an First People's Hospital, Nanjing Medical University, Jiangsu Huai'an 223300, China. wqq1059@sina.com.
authors.forename: Sheng
authors.initials: S
authors.lastname: Zhong
authors.forename: Qinquan
authors.initials: Q
authors.lastname: Wu
authors.forename: Su'an
authors.initials: S
authors.lastname: Sun
authors.forename: Biao
authors.initials: B
authors.lastname: Gu
authors.forename: Ming
authors.initials: M
authors.lastname: Zhao
authors.forename: Qiyou
authors.initials: Q
authors.lastname: Chen
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects; D057868:Anastomotic Leak; D003251:Constriction, Pathologic / Q000209:etiology; D003680:Deglutition Disorders / Q000209:etiology; D004938:Esophageal Neoplasms / Q000150:complications / Q000601:surgery*; D004940:Esophageal Stenosis / Q000209:etiology*; D016629:Esophagectomy / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors