title: Functional outcome after Ivor Lewis esophagectomy for cancer.
abstract: BACKGROUND
  Little is known on functional outcome after Ivor Lewis esophagectomy (ILE) with intrathoracic anastomosis.
  
  
  METHODS
  Patients who underwent ILE were identified from a prospective database. Clinicopathological data were retrieved and compared with functional outcome data based on patient self-assessment by a standard questionnaire. Predictive factors for selected functional complaints were identified with logistic regression analyses.
  
  
  RESULTS
  Three hundred and twenty-two patients (80.4% male, mean age 62 years) were studied. Indications for surgery were adenocarcinoma (62.4%), squamous cell carcinoma (28%), and HG Barrett dysplasia (7%). Preoperative chemoradiation (CRT) was administered to 42.5% of patients. Anastomotic leakage occurred in 5.6% and was associated with higher age and diabetes mellitus. Functional symptoms identified were reflux (39%), delayed gastric emptying (37%), dumping (21.4%), and anastomotic stenosis (16%). In the multivariate models, anastomotic stenosis was associated with smaller stapler diameter and presence of esophagitis. Postoperative reflux was associated with higher BMI, whereas dumping was predicted by female gender and age. The quality of life questionnaires revealed a good general health status in 82% of the patients.
  
  
  CONCLUSIONS
  Functional complaints after ILE consist of reflux, delayed gastric emptying, dumping, and dysphagia, and are affected by age, gender, BMI, diabetes mellitus, and stapler diameter.
authors.affiliation: Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium.
authors.forename: Annelies
authors.initials: A
authors.lastname: Deldycke
authors.affiliation: Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium.
authors.forename: Elke
authors.initials: E
authors.lastname: Van Daele
authors.affiliation: Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: Ceelen
authors.affiliation: Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium.
authors.forename: Yves
authors.initials: Y
authors.lastname: Van Nieuwenhove
authors.affiliation: Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium.
authors.forename: Piet
authors.initials: P
authors.lastname: Pattyn
mesh_terms: D000230:Adenocarcinoma / Q000503:physiopathology / Q000601:surgery; D000328:Adult; D000368:Aged; D057868:Anastomotic Leak / Q000209:etiology; D001471:Barrett Esophagus / Q000503:physiopathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000503:physiopathology / Q000601:surgery; D003680:Deglutition Disorders / Q000209:etiology; D004377:Dumping Syndrome / Q000209:etiology; D004938:Esophageal Neoplasms / Q000503:physiopathology* / Q000601:surgery* / Q000628:therapy; D016629:Esophagectomy / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D005746:Gastric Emptying; D005764:Gastroesophageal Reflux / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: dysphagia; esophageal cancer; quality of life