For a study, the researchers sought to determine the frequencies of anastomotic leak (AL) and conduit necrosis (CN) following esophagectomy and how they were treated in an international population. Patients who had an esophagectomy for esophageal cancer between April and December 2018 were included in this prospective multicenter cohort study (with 90 days of follow-up). The Esophageal Complications Consensus Group defined AL and CN as the significant outcomes. 90-day mortality and successful AL/CN management, defined as patients being alive 90 days after surgery and requiring no further AL/CN treatment, were the secondary outcomes. In total, 2,247 esophagectomies were performed in 137 institutions in 41 countries for the study. The AL rate (n=319) was 14.2%t, whereas the CN rate (n=60) was 2.7%. The total 90-day death rate for patients with AL was 11.3%, and it increased considerably with the severity of AL (Type 1: 3.2% vs Type 2: 13.2% vs Type 3: 24.7%, P<0.001); CN showed a similar trend. Primary care was successful in 69.6% of the 329 patients with AL/CN. Following management rounds, the rate of successful treatment rises, with cumulative success rates of 85.4% after secondary management and 88.1% after tertiary management, respectively. With increasing AL and CN severity, patient outcomes deteriorate considerably. Reintervention after unsuccessful initial anastomotic complication management could be beneficial; thus, surgeons should not be discouraged from pursuing other options.
