Study: Early postoperative endoscopy safe, effective for esophageal cancer patients

Editor's Note

Using early postoperative endoscopy to detect anastomotic leakage after minimally invasive esophagectomy does not increase postoperative adverse events, according to a study published February 10 in the journal Surgery.

Anastomotic leakage is one of the most severe adverse events of minimally invasive esophagectomy for esophageal cancer. Often deadly, it occurs in 10% to 20% of minimally invasive esophagectomy procedures, researchers note. Further, endoscopy has unique advantages in detecting the condition, such as direct visualization and detection of gastric graft ischemia that CT scans cannot recognize. However, there is a “general reluctance by the majority of surgeons” to employ endoscopy.

Motivated by these concerns about the safety and effectiveness of the procedure, researchers focused on 436 patients at Tangdu Hospital in Xi’an, China who underwent minimally invasive esophagectomy from January 2017 to June 2021. Of that group, 134 had an endoscopy within 72 hours after surgery. Both before and after propensity score matching to adjust for differences in baseline characteristics, early postop endoscopy did not increase in the incidents of adverse events or in-hospital mortality. In fact, rates of anastomotic leakage and the length of mean postoperative hospital stay were both lower among patients who underwent postop endoscopy.

Based on these results, postoperative endoscopy can be useful to guide early prediction and intervention strategies for anastomotic leakage, the researchers conclude.