{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T02:11:27Z","timestamp":1782180687595,"version":"3.54.5"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T00:00:00Z","timestamp":1655683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,31]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>Anastomotic leakage after esophagectomy has serious consequences. In Ivor Lewis esophagectomy, a shorter and possibly better vascularized gastric conduit is created than in McKeown esophagectomy. Intrathoracic anastomoses can additionally be wrapped in omentum and concealed behind the pleura (\u201cflap and wrap\u201d reconstruction). Aims of this observational study were to assess the anastomotic leakage incidence after transhiatal esophagectomy (THE), McKeown esophagectomy (McKeown), Ivor Lewis esophagectomy (IL) without \u201cflap and wrap\u201d reconstruction, and IL with \u201cflap and wrap\u201d reconstruction. Consecutive patients undergoing esophagectomy at a tertiary referral center between January 2013 and April 2019 were included. Primary outcome was the anastomotic leakage rate. Secondary outcomes were postoperative outcomes, mortality, and 3-year overall survival. A total of 463 patients were included. The anastomotic leakage incidence after THE (n\u2009=\u200937), McKeown (n\u2009=\u200997), IL without \u201cflap and wrap\u201d reconstruction (n\u2009=\u200939), and IL with \u201cflap and wrap\u201d reconstruction (n\u2009=\u2009290) were 24.3, 32.0, 28.2, and 7.2% (P\u2009&amp;lt;\u20090.001). THE and IL with \u201cflap and wrap\u201d reconstruction required fewer reoperations for anastomotic leakage (0 and 1.4%) than McKeown and IL without \u201cflap and wrap\u201d reconstruction (6.2 and 17.9%, P\u2009&amp;lt;\u20090.001). Fewer anastomotic leakages are observed after Ivor Lewis esophagectomy with \u201cflap and wrap\u201d reconstruction compared to transhiatal, McKeown and Ivor Lewis esophagectomy without \u201cflap and wrap\u201d reconstruction. The \u201cflap and wrap\u201d reconstruction seems a promising technique to further reduce anastomotic leakages and its severity in esophageal cancer patients who have an indication for Ivor Lewis esophagectomy.<\/jats:p>","DOI":"10.1093\/dote\/doac036","type":"journal-article","created":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T21:52:21Z","timestamp":1655761941000},"source":"Crossref","is-referenced-by-count":13,"title":["Improved anastomotic leakage rates after the \u201cflap and wrap\u201d reconstruction in Ivor Lewis esophagectomy for cancer"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1194-5280","authenticated-orcid":false,"given":"Annelijn E","family":"Slaman","sequence":"first","affiliation":[{"name":"Department of Surgery, Amsterdam UMC location AMC, University of Amsterdam, Cancer Center Amsterdam , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wietse J","family":"Eshuis","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam UMC location AMC, University of Amsterdam, Cancer Center Amsterdam , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark I","family":"van Berge Henegouwen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam UMC location AMC, University of Amsterdam, Cancer Center Amsterdam , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne S","family":"Gisbertz","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam UMC location AMC, University of Amsterdam, Cancer Center Amsterdam , Amsterdam , The 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