Functional outcome after Ivor Lewis esophagectomy for cancer. Issue 1 (3rd November 2015)

• Record Type: Journal Article
• Authors: Deldycke, Annelies; Van Daele, Elke; Ceelen, Wim; Van Nieuwenhove, Yves; Pattyn, Piet
• Is Part Of: Journal of surgical oncology. Volume 113:Issue 1(2016)
• Page Start: 24
• Page End: 28
• Publication Date: 2015-11-03
• Subjects: esophageal cancer -- quality of life -- dysphagia; Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.24084
• Languages: English
• ISSNs: 0022-4790

Abstract

Abstract : Background: Little is known on functional outcome after Ivor Lewis esophagectomy (ILE) with intrathoracic anastomosis. Methods: Patients who underwent ILE were identified from a prospective database. Clinicopathological data were retrieved and compared with functional outcome data based on patient self‐assessment by a standard questionnaire. Predictive factors for selected functional complaints were identified with logistic regression analyses. Results: Three hundred and twenty‐two patients (80.4% male, mean age 62 years) were studied. Indications for surgery were adenocarcinoma (62.4%), squamous cell carcinoma (28%), and HG Barrett dysplasia (7%). Preoperative chemoradiation (CRT) was administered to 42.5% of patients. Anastomotic leakage occurred in 5.6% and was associated with higher age and diabetes mellitus. Functional symptoms identified were reflux (39%), delayed gastric emptying (37%), dumping (21.4%), and anastomotic stenosis (16%). In the multivariate models, anastomotic stenosis was associated with smaller stapler diameter and presence of esophagitis. Postoperative reflux was associated with higher BMI, whereas dumping was predicted by female gender and age. The quality of life questionnaires revealed a good general health status in 82% of the patients. Conclusions: Functional complaints after ILE consist of reflux, delayed gastric emptying, dumping, and dysphagia, and are affected by age, gender, BMI, diabetes mellitus, and stapler diameter. J. Surg. Oncol. 2016;113:24–28 . © 2015 Wiley Periodicals, Inc.