{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T06:17:30Z","timestamp":1768457850523,"version":"3.49.0"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2020,12,17]],"date-time":"2020-12-17T00:00:00Z","timestamp":1608163200000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>A 66-year-old man underwent a minimally invasive oesophagectomy for oesophageal adenocarcinoma. Surgery and recovery were routine; however, he represented 8\u00a0days later with a massive upper gastrointestinal bleed. He was stabilized, but over a 2-week period experienced several bleeds requiring transfusion and multiple endoscopies, all showing a prominent luminal vessel at the oesophago-gastric (OG) anastomosis. Haemostatic clipping was attempted resulting in pulsatile bleeding and transfer to the radiology suite where angiography showed extravasation of contrast at the OG anastomosis from the terminal portion of the gastro-epiploic arcade. Coil embolization was successful and did not result in ischaemia. It was our standard to construct the OG anastomosis with the end-to-end anastomosis circular stapler (DST\u2122 Series EEA\u2122), 4.8-mm staple height. However, we now use the 3.5-mm staple height for improved haemostasis and ensure that the area for anastomosis is cleared of omental tissue so as not to incorporate a visible vessel.<\/jats:p>","DOI":"10.1093\/jscr\/rjaa471","type":"journal-article","created":{"date-parts":[[2020,10,21]],"date-time":"2020-10-21T19:11:41Z","timestamp":1603307501000},"source":"Crossref","is-referenced-by-count":0,"title":["Challenging delayed bleeding after an Ivor Lewis oesophagectomy"],"prefix":"10.1093","volume":"2020","author":[{"given":"Sean","family":"Liddle","sequence":"first","affiliation":[{"name":"Division of General Surgery, Peter Lougheed Hospital, Calgary, Alberta T1Y 6J4, Canada"},{"name":"Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 1N4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anirudh","family":"Mirakhur","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 1N4, Canada"},{"name":"Division of Radiology, Peter Lougheed Hospital, Calgary, Alberta T1Y 6J4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Estifanos","family":"Debru","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Peter Lougheed Hospital, Calgary, Alberta T1Y 6J4, Canada"},{"name":"Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 1N4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,12,17]]},"reference":[{"key":"2020121813592971500_ref1","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1016\/j.athoracsur.2015.03.124","article-title":"Endoscopic management of early upper gastrointestinal bleeding after minimally invasive ivor-lewis esophagectomy","volume":"101","author":"Zhang","year":"2016","journal-title":"Ann Thorac 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