{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T01:31:27Z","timestamp":1749691887800},"reference-count":27,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,4,14]],"date-time":"2015-04-14T00:00:00Z","timestamp":1428969600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Esophageal anastomotic leak is associated with high morbidity and mortality and potentially lethal if not recognized promptly and treated aggressively. While many studies have attempted to delineate the surgical techniques associated with lower rates of anastomotic leak, few have attempted to determine its long term effects on adjuvant therapy and patient quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed our prospective 350 patient esophageal\u2010gastric database and found 194 esophageal anastomoses performed from 1994 to 2013. Leaks were classified based on timing, severity, and location. We then compared their postoperative courses of adjuvant treatment, morbidity\/mortality, and quality of life measured by Karnofsky performance status and EORTC score. Statistical correlations were calculated with \u03c7<jats:sup>2<\/jats:sup>, <jats:italic>T<\/jats:italic>\u2010test, Kaplain\u2013Meier, ANOVA, and Cox Regression analyses as appropriate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 194 patients receiving esophageal anastomoses for cancer, 35 (18%) developed clinically diagnosed anastomotic leak 27 from esophagogastric and 8 from esophagojejunal. These groups were similar in preoperative history, preoperative staging, and type of tumor. Type of operation and variations in operative technique did not significantly affect leak rate. Patients with a leak were more likely to require intraoperative transfusion (47.1% vs. 24.1%, <jats:italic>P<\/jats:italic>\u2009=\u20090.013). As expected, they had a greater prevalence of perioperative complications to include pneumonia (38.6% vs. 16.3%, <jats:italic>P<\/jats:italic>\u2009=\u20090.001), pulmonary embolus (11.3% vs. 4.3%, <jats:italic>P<\/jats:italic>\u2009=\u20090.043), ileus (11.4% vs. 1.6%, <jats:italic>P<\/jats:italic>\u2009=\u20090.006%), empyema (11.4% vs. 0%, <jats:italic>P<\/jats:italic>\u2009&gt;\u20090.001), and catheter related blood stream infections (8.6% vs. 0%, <jats:italic>P<\/jats:italic>\u2009=\u20090.001). Despite this increase in perioperative morbidity, there was no statistically significant difference in 90 day peri\u2010operative mortality (2.8% vs. 2.3%) with similar ability to receive adjuvant therapy (38.6% vs. 48.0%, <jats:italic>P<\/jats:italic>\u2009=\u20090.303), quality of life scores (93.2 vs. 93.1, <jats:italic>P<\/jats:italic>\u2009=\u20090.9), and survival at 12 months (93% vs. 94%, <jats:italic>P<\/jats:italic>\u2009=\u20090.3).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Anastomotic leak after oncologic resection does not preclude adjuvant therapy and, when managed appropriately, does not affect long term performance status or survival. <jats:italic>J. Surg. Oncol. 2015 111:855\u2013861<\/jats:italic>. \u00a9 2014 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.23902","type":"journal-article","created":{"date-parts":[[2015,4,14]],"date-time":"2015-04-14T16:01:50Z","timestamp":1429027310000},"page":"855-861","source":"Crossref","is-referenced-by-count":3,"title":["Esophageal anastomotic leak does not affect ability to receive adjuvant treatment"],"prefix":"10.1002","volume":"111","author":[{"given":"Robert C.G.","family":"Martin","sequence":"first","affiliation":[{"name":"Department of Surgery Division of Surgical Oncology University of Louisville Louisville Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Russell W.","family":"Farmer","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Surgical Oncology University of Louisville Louisville Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. Charles St.","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Surgical Oncology University of Louisville Louisville Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly M.","family":"McMasters","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Surgical Oncology University of Louisville Louisville Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles R.","family":"Scoggins","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Surgical Oncology University of Louisville Louisville Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,4,14]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"SEER SEER Database 2007 NCI."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.05.081"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semtcvs.2006.11.005"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(01)02601-7"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.21510"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2050.2009.00995.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2004.02.034"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2004.09.018"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200005000-00003"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.11.042"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(98)00002-6"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-007-3541-5"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1159\/000084544"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/30515892"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-011-0519-6"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-010-1249-0"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1381\/096089206776116390"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1381\/096089205774512410"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-008-9851-x"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2008.04.039"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1112088"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa055531"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2003.11.022"},{"key":"e_1_2_6_25_1","first-page":"384","article-title":"Evaluating cancer patients for rehabilitation potential","volume":"155","author":"O'Toole DM","year":"1991","journal-title":"West J Med"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2010.12.026"},{"key":"e_1_2_6_27_1","first-page":"387","article-title":"Impact of post\u2010operative complications on quality of life after pancreatectomy","volume":"13","author":"Mbah N","year":"2012","journal-title":"JOP"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(01)00559-1"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjso.23902","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjso.23902","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.23902","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T20:16:56Z","timestamp":1694895416000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.23902"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,4,14]]},"references-count":27,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2015,6]]}},"alternative-id":["10.1002\/jso.23902"],"URL":"https:\/\/doi.org\/10.1002\/jso.23902","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,4,14]]}}}