title: Does Routine Endoscopy or Contrast Swallow Study After Esophagectomy and Gastric Tube Reconstruction Change Patient Management?
abstract: Anastomotic leakage is a severe complication after esophagectomy. The objective was to investigate the diagnostic and predictive value of routine contrast swallow study and endoscopy for the detection of anastomotic dehiscence in patients after esophagectomy.
  
  
  
  All patients who underwent contrast swallow and/or endoscopy within 7 days after oesophagectomy for cancer between January 2005 and December 2009 were selected from an institutional database.
  
  
  
  Some 173 patients underwent endoscopy, and 184 patients underwent a contrast swallow study. The sensitivity of endoscopy for anastomotic leakage requiring intervention is 56 %, specificity 41 %, positive predictive value (PPV) 8 %, and negative predictive value (NPV) 95 %. The sensitivity of contrast swallow study for detecting leakage requiring intervention in patients without signs of leakage was 20 %, specificity 20 %, PPV 3 %, and NPV 97 %.
  
  
  
  In patients without clinical suspicion of leakage, there is no benefit to perform routine examinations.
authors.affiliation: Department of Surgery, Erasmus MC University Medical Centre Rotterdam, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: Nederlof
authors.affiliation: Department of Surgery, Erasmus MC University Medical Centre Rotterdam, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: de Jonge
authors.affiliation: Department of Surgery, Erasmus MC University Medical Centre Rotterdam, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: de Vringer
authors.affiliation: Department of Surgery, Erasmus MC University Medical Centre Rotterdam, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: T C K
authors.initials: TC
authors.lastname: Tran
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: M C W
authors.initials: MC
authors.lastname: Spaander
authors.affiliation: Department of Surgery, Erasmus MC University Medical Centre Rotterdam, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: H W
authors.initials: HW
authors.lastname: Tilanus
authors.affiliation: Department of Surgery, Erasmus MC University Medical Centre Rotterdam, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. b.wijnhoven@erasmusmc.nl.
authors.forename: B P L
authors.initials: BP
authors.lastname: Wijnhoven
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D057868:Anastomotic Leak / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D003287:Contrast Media; D003955:Diagnostic Tests, Routine; D016099:Endoscopy, Gastrointestinal; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D012189:Retrospective Studies; D013270:Stomach / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D014283:Triiodobenzoic Acids
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol
keywords: Anastomosis; Complication; Contrast swallow; Endoscopy; Esophagectomy; Leakage