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Background <p>Esophagectomy (OE) remains a complex procedure with a considerable risk of severe postoperative complications. There is conflicting evidence if major postoperative complications impair long-term oncological survival. This retrospective study was designed to retest the hypothesis that complications after OE impact on long-term survival in a large and highly standardized cohort of esophageal cancer patients.</p> Materials and methods <p>733 patients who underwent Ivor Lewis esophagectomy (IL-OE) for cancer from 2016 to 2021 at our tertiary center were analysed from a prospectively maintained database. Postoperative complications were correlated to overall survival.</p> Results <p>Neither occurrence of major complications ≥ Clavien-Dindo (CD) IIIB (Median OS not reached in both groups, <i>p</i> = 0.45, HR 1.12) nor AL (Median OS not reached for no AL vs. 50 months for AL, <i>p</i> = 0.49, HR 0.96) nor pulmonary complications (Median OS not reached in both groups, <i>p</i> = 0.61, HR 0.76) had an impact on overall survival. However, the necessity for postoperative readmission to ICU (reaICU) had a significant impact on overall survival (Median OS not reached for no reaICU vs. 40 months for reaICU, <i>p</i> = 0.037, HR 1.54). Mean follow up was 27 months.</p> Conclusion <p>Among all variables, only ICU readmission significantly affected overall survival. Postoperative complications and in particular anastomotic leakage after IL-OE, per se, may have a less significant impact on overall survival than previously anticipated. This might be due to a highly sufficient management of complications that progressively avoids requirement of severe septic complications and intensive care treatment.</p>

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Complications and survival after Ivor Lewis esophagectomy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月1日

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  • A. Abu Hejleh,
  • J. Lemties,
  • I. Kreutzer,
  • N. M. Wirsik,
  • D. T. Krauss,
  • S. Torabi,
  • J-O Jung,
  • W. Schröder,
  • H. A. Schlößer,
  • T. Schmidt,
  • H. F. Fuchs,
  • C. J. Bruns,
  • L. M. Schiffmann

摘要

Background

Esophagectomy (OE) remains a complex procedure with a considerable risk of severe postoperative complications. There is conflicting evidence if major postoperative complications impair long-term oncological survival. This retrospective study was designed to retest the hypothesis that complications after OE impact on long-term survival in a large and highly standardized cohort of esophageal cancer patients.

Materials and methods

733 patients who underwent Ivor Lewis esophagectomy (IL-OE) for cancer from 2016 to 2021 at our tertiary center were analysed from a prospectively maintained database. Postoperative complications were correlated to overall survival.

Results

Neither occurrence of major complications ≥ Clavien-Dindo (CD) IIIB (Median OS not reached in both groups, p = 0.45, HR 1.12) nor AL (Median OS not reached for no AL vs. 50 months for AL, p = 0.49, HR 0.96) nor pulmonary complications (Median OS not reached in both groups, p = 0.61, HR 0.76) had an impact on overall survival. However, the necessity for postoperative readmission to ICU (reaICU) had a significant impact on overall survival (Median OS not reached for no reaICU vs. 40 months for reaICU, p = 0.037, HR 1.54). Mean follow up was 27 months.

Conclusion

Among all variables, only ICU readmission significantly affected overall survival. Postoperative complications and in particular anastomotic leakage after IL-OE, per se, may have a less significant impact on overall survival than previously anticipated. This might be due to a highly sufficient management of complications that progressively avoids requirement of severe septic complications and intensive care treatment.