Subtotal Gastric Conduit Limits Postoperative Complications in Esophageal Cancer

A research team compared the differences in postoperative complications between narrow gastric conduit (NGC) and subtotal gastric conduit (SGC) in patients with esophageal cancer.

Prior studies evaluated the efficacy of both NGC and SGC for cervical esophagogastrostomy following esophagectomy. Further research is needed to determine which conduit provides better outcomes and involves less postoperative complications.

The retrospective study, led by Dr. Ken Sasaki, of Kagoshima University in Japan, and published in Esophagus, analyzed the differences in postoperative complications between NGC and SGC when applied in cervical circular-tapered esophagogastrostomy following esophagectomy. Investigators used a propensity score-matched analysis to compare results from NGC and SGC.

Of the 577 patients participating in the study, 77 were in both the SGC and the NGC groups following propensity score matching. Both groups used the same clinical characteristics.

Researchers reported that the anastomotic leakage rate in the SGC group appeared significantly lower than in the NGC group (5% vs 22%, respectively; P<.01). In the SGC group, the anastomotic stenosis rate was significantly higher than in the NGC group (16% vs 5%, respectively; P=.03).

Significant independent factors associated with anastomotic leakage, as shown by multivariate logistic analysis, were NGC (odds ratio [OR], 8.58; P<.01), subcutaneous route (OR, 6.49; P<.01), and age (OR, 5.21; P<.03).

Multivariate logistic analysis also demonstrated that SGC was a significant independent factor associated with anastomotic stricture (OR, 4.91; P=.01)

Dr. Sasaki and colleagues noted that SGC surpassed the results of NGC. “In cervical circular-stapled esophagogastrostomy after esophagectomy, SGC was superior to NGC in terms of reducing the risk of anastomotic leakage, although the risk of anastomotic stricture needs to be resolved,” they wrote.