{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T03:07:13Z","timestamp":1768792033593,"version":"3.49.0"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T00:00:00Z","timestamp":1622678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The Ivor Lewis esophagectomy\u00a0(ILE) remains the procedure of choice for localized middle or lower esophageal carcinoma. Nevertheless, anastomotic leak remains a common complication with rates from 3% to 25% and a stricture rate as high as 40%. The frequency of these complications suggests that the procedure itself may have inherent limitations including the use of potentially ischemic tissue for the esophagogastric anastomosis. We introduce a modified technique that reduces operative steps, preserves blood supply, and uses a modified esophagogastric anastomosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All consecutive patients undergoing ILE\u00a0with the described modified technique were identified. An esophagram was performed on postoperative day six or seven. To ensure that all cases were identified, anastomotic leaks were defined as any radiographic evidence of contrast extravasation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 110 patients underwent the modified esophagectomy with 2 anastomotic leaks (1.82%) and zero strictures. There was 1 late death but no early deaths (&lt;30 or 90 days) or early re\u2010admissions (&lt;30 days). The average number of risk factors was 2.12, and 98 patients (90%) had at least 1 risk factor in their medical history.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The modifications proposed simplify procedural steps, limit unnecessary dissection and introduce a technique that ends the practice of connecting ischemic tissue. We believe this technique contributes to surgical durability and reduces the rate of postoperative leak and eliminates stricture.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.26550","type":"journal-article","created":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T11:21:02Z","timestamp":1622805662000},"page":"529-539","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Major modifications to minimize thoracic esophago\u2010gastric leak and eradicate esophageal stricture after Ivor Lewis esophagectomy"],"prefix":"10.1002","volume":"124","author":[{"given":"Brian","family":"Housman","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai Mount Sinai Health System  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong\u2010Seok","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai Mount Sinai Health System  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Wolf","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai Mount Sinai Health System  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Nicastri","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai Mount Sinai Health System  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai Mount Sinai Health System  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nabil","family":"Rizk","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai Mount Sinai Health System  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arno","family":"Housman","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai Mount Sinai Health System  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai Mount Sinai Health System  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ardeshir","family":"Hakami","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai Mount Sinai Health System  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7718-7422","authenticated-orcid":false,"given":"Raja M.","family":"Flores","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai Mount Sinai Health System  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,3]]},"reference":[{"issue":"3","key":"e_1_2_9_2_1","first-page":"515","article-title":"Ivor Lewis esophagectomy","volume":"5","author":"Bains MS","year":"1995","journal-title":"Chest Surg Clin N Am"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.07.119"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2004.09.018"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000322014"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.21510"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.18003413304"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000195979.25659.fe"},{"key":"e_1_2_9_9_1","volume-title":"Shields' General Thoracic Surgery","author":"LoCicero J","year":"2019"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","unstructured":"ReedC. Technique of Open Ivor Lewis Esophagectomy.Oper\u00a0Tech\u00a0Thoracic\u00a0Cardiovasc\u00a0Surg.14(3):160\u2010175.","DOI":"10.1053\/j.optechstcvs.2009.06.001"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(92)90077-H"},{"key":"e_1_2_9_12_1","first-page":"294","volume-title":"Thoracic Surgery Atlas","author":"Ferguson MK","year":"2007"},{"key":"e_1_2_9_13_1","volume-title":"Mastery of Surgery","author":"Fischer JE","year":"2007"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1159\/000129436"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1006\/jsre.1997.5239"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ags3.12220"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.11.045"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(00)70183-8"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2018.09.001"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000179645.17384.12"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2050.2011.01304.x"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2007.09.016"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2018.03.025"},{"issue":"7","key":"e_1_2_9_24_1","first-page":"1155","article-title":"Simultaneous assessment of gastric accommodation and emptying: studies with liquid and solid meals","volume":"45","author":"Simonian HP","year":"2004","journal-title":"J Nucl Med"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.51.suppl_1.i59"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-009-0342-5"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLE.0000000000000422"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.26550","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jso.26550","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.26550","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T16:46:21Z","timestamp":1693327581000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.26550"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,3]]},"references-count":26,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1002\/jso.26550"],"URL":"https:\/\/doi.org\/10.1002\/jso.26550","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,3]]},"assertion":[{"value":"2021-02-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}