{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T20:25:03Z","timestamp":1768249503426,"version":"3.49.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2010,3,16]],"date-time":"2010-03-16T00:00:00Z","timestamp":1268697600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,4,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>A possible advantage of cervical oesophagogastrostomy over intrathoracic anastomosis after oesophagectomy is the presumed mild clinical course of cervical anastomotic leakage. The incidence and consequences of intrathoracic manifestations after cervical anastomotic leakage remain unclear, and were investigated in this study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Consecutive patients undergoing potentially curative transhiatal oesophagectomy (THO) or transthoracic oesophagectomy (TTO) with cervical oesophagogastrostomy between 1993 and 2007 were included. Intrathoracic manifestations after cervical anastomotic leakage were compared following THO and TTO. Multivariable logistic regression analysis was used to identify potential risk factors for intrathoracic manifestations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Seventy-nine (15\u00b78 per cent) of 501 patients developed anastomotic leakage after THO compared with 50 (15\u00b73 per cent) of 327 after TTO (P = 0\u00b7853). Intrathoracic manifestations developed in 21 (27 per cent) and 22 (44 per cent) patients respectively (P = 0\u00b7041). A transthoracic approach was the only independent predictor of the development of intrathoracic manifestations in patients with cervical leakage (odds ratio 2\u00b760; P = 0\u00b7022). Total hospital stay (P &amp;lt; 0\u00b7001), intensive care unit stay (P &amp;lt; 0\u00b7001) and in-hospital mortality (P = 0\u00b7035) were greater in patients with intrathoracic manifestations than in those without.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Intrathoracic manifestations of cervical anastomotic leakage are associated with a prolonged hospital stay, carry a higher mortality and occur more frequently after TTO than THO.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.6971","type":"journal-article","created":{"date-parts":[[2010,3,16]],"date-time":"2010-03-16T12:23:31Z","timestamp":1268742211000},"page":"726-731","source":"Crossref","is-referenced-by-count":47,"title":["Intrathoracic manifestations of cervical anastomotic leaks after transhiatal and transthoracic oesophagectomy"],"prefix":"10.1093","volume":"97","author":[{"given":"M","family":"van Heijl","sequence":"first","affiliation":[{"name":"Department of Surgery Academic Medical Centre, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A K S","family":"van Wijngaarden","sequence":"additional","affiliation":[{"name":"Department of Surgery Academic Medical Centre, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S M","family":"Lagarde","sequence":"additional","affiliation":[{"name":"Department of Surgery Academic Medical Centre, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O R C","family":"Busch","sequence":"additional","affiliation":[{"name":"Department of Surgery Academic Medical Centre, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J J B","family":"van Lanschot","sequence":"additional","affiliation":[{"name":"Department of Surgery Erasmus Medical Centre, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M I","family":"van Berge Henegouwen","sequence":"additional","affiliation":[{"name":"Department of Surgery Academic Medical Centre, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2010,3,16]]},"reference":[{"key":"2021070910452788700_bib1","first-page":"71","article-title":"Mortality secondary to esophageal anastomotic leak","volume":"10","author":"Alanezi","year":"2004","journal-title":"Ann Thorac Cardiovasc Surg"},{"key":"2021070910452788700_bib2","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1007\/s00595-007-3541-5","article-title":"Hand-sewn cervical anastomosis versus stapled intrathoracic anastomosis after esophagectomy for middle or lower thoracic esophageal cancer: a prospective randomized controlled study","volume":"37","author":"Okuyama","year":"2007","journal-title":"Surg Today"},{"key":"2021070910452788700_bib3","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1097\/01.sla.0000098624.04100.b1","article-title":"Cervical or thoracic anastomosis after esophageal resection and gastric tube reconstruction: a prospective randomized trial comparing sutured neck anastomosis with stapled intrathoracic anastomosis","volume":"238","author":"Walther","year":"2003","journal-title":"Ann Surg"},{"key":"2021070910452788700_bib4","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/S0022-5223(19)34794-4","article-title":"Anastomotic complications after esophagectomy for cancer. 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