{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T14:24:04Z","timestamp":1774448644383,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,5,26]],"date-time":"2022-05-26T00:00:00Z","timestamp":1653523200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,5,26]],"date-time":"2022-05-26T00:00:00Z","timestamp":1653523200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2022,5,26]],"date-time":"2022-05-26T00:00:00Z","timestamp":1653523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81672291, 31071210"],"award-info":[{"award-number":["81672291, 31071210"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Blood supply is especially weak near the gastric fundus. Making the anastomosis in this area would increase the risk of anastomotic leakage (AL). In cervical anastomosis, the gastric conduit needs to travel through the thorax. Therefore, the relative length between the stomach and the thorax is an essential factor in deciding if the poorly supplied area could be removed. This study was to explore if a small relative gastric length was a risk of cervical AL. If all other conditions are equal, could intrathoracic anastomosis be a better choice?<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent esophagectomy with a preoperative barium swallow in West China Hospital between 2014 and 2017 were included. The length of the greater curvature and the thorax were obtained from the barium esophagogram. The ratio between the length of the greater curvature and the thorax was the relative gastric length calculated from the greater curvature (RGL\u2010G).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 782 patients were enrolled in the final analysis. The cervical AL group had a significantly higher ratio of patients with an RGL\u2010G less than 1.3 (26.7% vs. 8.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.003). The multivariate logistic regression proved that RGL\u2010G less than 1.3 was a risk factor for cervical anastomotic leakage (<jats:italic>p<\/jats:italic>\u2009=\u20090.012). Correspondingly, RGL\u2010G less than 1.3 was not a risk factor (6.3% vs. 14.3%, <jats:italic>p<\/jats:italic>\u2009=\u20090.289) in the intrathoracic anastomosis group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>RGL\u2010G less than 1.3 was a new risk factor for cervical AL, but it would not be a problem for intrathoracic anastomosis.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-022-06579-w","type":"journal-article","created":{"date-parts":[[2022,5,26]],"date-time":"2022-05-26T15:06:12Z","timestamp":1653577572000},"page":"2235-2242","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A New Risk Factor for Cervical Anastomotic Leakage\u2010Role of The Relative Gastric Length in the Surgical Treatment of Esophageal Cancer"],"prefix":"10.1002","volume":"46","author":[{"given":"Peng","family":"Yao","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery West China Hospital, Sichuan University 37 Guoxue 610041 Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pathology West China Hospital, Sichuan University Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery West China Hospital, Sichuan University 37 Guoxue 610041 Chengdu China"},{"name":"Department of Thoracic Surgery Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ze\u2010Guo","family":"Zhuo","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery West China Hospital, Sichuan University 37 Guoxue 610041 Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi\u2010Jie","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery West China Hospital, Sichuan University 37 Guoxue 610041 Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gu\u2010Ha","family":"Alai","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery West China Hospital, Sichuan University 37 Guoxue 610041 Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi\u2010Dan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery West China Hospital, Sichuan University 37 Guoxue 610041 Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,5,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010018\u20106437\u20102"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002171"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.12.13"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.13972"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10728"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.2147\/OTT.S169488"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2016.07.010"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ags3.12315"},{"key":"e_1_2_9_10_1","first-page":"14","article-title":"Management of intrathoracic and cervical anastomotic leakage after esophagectomy for esophageal cancer: a systematic review","volume":"4","author":"Verstegen MA\u2010OX","year":"2019","journal-title":"World J Surg Emerg Surg"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010019\u201007331\u2010w"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/dox006"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13019\u2010019\u20100864\u20104"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.21037\/apm\u201019\u2010569"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2014.05.023"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003169"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10388\u2010017\u20100585\u20105"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2016.10.016"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2019.12.084"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2019.10.032"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2017.03.173"},{"key":"e_1_2_9_22_1","first-page":"1","article-title":"Long\u2010term health\u2010related quality of life after mckeown and ivor lewis esophagectomy for esophageal carcinoma","volume":"00","author":"Jezerskyte E","year":"2020","journal-title":"Dis Esophagus"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soc.2018.11.009"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-022-06579-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00268-022-06579-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-022-06579-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-022-06579-w","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T20:27:13Z","timestamp":1703708833000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-022-06579-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,26]]},"references-count":22,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1007\/s00268-022-06579-w"],"URL":"https:\/\/doi.org\/10.1007\/s00268-022-06579-w","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,26]]},"assertion":[{"value":"6 April 2022","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 May 2022","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"No conflict of interest was declared.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}