The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Login
EN
+7 (495) 482-4118
+7 (495) 482-4329
+8 800 250-18-12
  • (toll-free number for subscriptions)
    Mon-Fri from 10 a.m. to 6 p.m.

  • © 1998-2026
+7 (495) 482-43-29
EN
All journals
Journal
Year
Year
Search result: 0

E.A. Toneev

Regional Clinical Oncology Center;
Ulyanovsk State University

O.V. Pikin

Hertzen Moscow Cancer Research Center

R.F. Shagdaleev

Ulyanovsk State University

Prediction of cervical anastomosis failure after McKeown esophagectomy

Authors:

E.A. Toneev, O.V. Pikin, R.F. Shagdaleev

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2025;(10): 63‑72

DOI: 10.17116/hirurgia202510163

Read: 776 times

Contact the author
Table of contents

PREDICTION OF CERVICAL ANASTOMOSIS FAILURE AFTER MCKEOWN ESOPHAGECTOMY
PREDICTION OF CERVICAL ANASTOMOSIS FAILURE AFTER MCKEOWN ESOPHAGECTOMY

To cite this article:

Toneev EA, Pikin OV, Shagdaleev RF. Prediction of cervical anastomosis failure after McKeown esophagectomy. Pirogov Russian Journal of Surgery. 2025;(10):63‑72. (In Russ.)
https://doi.org/10.17116/hirurgia202510163

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)
МСФ на ЯМ
Использование инфографики авторами научных работ
Abstract:

OBJECTIVE

To identify the risk factors of cervical anastomosis failure after McKeown esophagectomy and to create a prognostic model predicting the risk of anastomosis failure.

MATERIAL AND METHODS

There were 69 esophagectomies between January 1, 2019 and December 31, 2023 for cancer of the middle thoracic esophagus. Significant predictors of cervical anastomosis failure were identified.

RESULTS

The incidence of anastomosis failure after McKeown surgery was 18.8%. Logistic regression analysis showed that platelet-lymphocyte ratio (OR=1.141; 95% CI: 1.003—1.297), prognostic nutritional index (OR=0.576; 95% CI: 0.339—0.979), and systemic immune-inflammation index (OR=1.010; 95% CI: 1.004—1.016) were independent risk factors of anastomosis failure after McKeown esophagectomy. AUC was 0.953 ± 0.042 (95% CI 0.872—1.000). The model was significant (p<0.001). Sensitivity and specificity of the model were 84.6% and 87.5%, respectively. Furthermore, we developed a nomogram for predicting cervical anastomosis failure after McKeown surgery using artificial intelligence and machine learning. A comprehensive analysis and validation of prognostic model demonstrated its significance.

CONCLUSIONS

PNI, NLR and SII are significant predictive factors of cervical anastomotic leakage after McKeown esophagectomy. A nomogram was developed to predict the probability of anastomotic leakage.

Keywords:

McKeown esophagectomy
cervical anastomosis failure
nomogram for cervical anastomosis failure after McKeown esophagectomy

Authors:

E.A. Toneev

Regional Clinical Oncology Center;
Ulyanovsk State University

O.V. Pikin

Hertzen Moscow Cancer Research Center

R.F. Shagdaleev

Ulyanovsk State University

Received:

10.11.2024

Accepted:

15.12.2024

Close metadata

References:

  1. Morgan E, Soerjomataram I, Rumgay H, Coleman HG, Thrift AP, Vignat J, et al. The Global Landscape of Esophageal Squamous Cell Carcinoma and Esophageal Adenocarcinoma Incidence and Mortality in 2020 and Projections to 2040: New Estimates From GLOBOCAN 2020. Gastroenterology. 2022;163(3):649-658.e2.  https://doi.org/10.1053/j.gastro.2022.05.054
  2. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: Cancer J Clinicians. 2021;71(3):209-249.  https://doi.org/10.3322/caac.21660
  3. Rumgay H, Arnold M, Laversanne M, Whiteman DC, Thrift AP, Wei W, et al. International Trends in Esophageal Squamous Cell Carcinoma and Adenocarcinoma Incidence. Am J Gastroenterol. 2021;116(5):1072-1076. https://doi.org/10.14309/ajg.0000000000001121
  4. Eyck BM, van Lanschot JJB, Hulshof MCCM, van der Wilk BJ, Shapiro J, van Hagen P, et al. Ten-Year Outcome of Neoadjuvant Chemoradiotherapy Plus Surgery for Esophageal Cancer: The Randomized Controlled CROSS Trial. J Clin Oncol. 2021;39(18):1995-2004. https://doi.org/10.1200/JCO.20.03614
  5. Manghelli JL, Ceppa DP, Greenberg JW, Blitzer D, Hicks A, Rieger KM, Birdas TJ. Management of anastomotic leaks following esophagectomy: when to intervene? J Thorac Dis. 2019;11(1):131-137.  https://doi.org/10.21037/jtd.2018.12.13
  6. Turkyilmaz A, Eroglu A, Aydin Y, Tekinbas C, Muharrem Erol M, Karaoglanoglu N. The management of esophagogastric anastomotic leak after esophagectomy for esophageal carcinoma. Dis Esophagus. 2009;22(2):119-26.  https://doi.org/10.1111/j.1442-2050.2008.00866.x
  7. Takahashi C, Shridhar R, Huston J, Meredith K. Esophagectomy from then to now. J Gastrointest Oncol. 2018;9(5):903-909.  https://doi.org/10.21037/jgo.2018.08.15
  8. Yakovlev S.V., Zhuravleva M.V., Protsenko D.N. et al. Antibiotic stewardship program for inpatient care. Clinical guidelines for Moscow hospitals. Consilium Medicum. 2017;19(7.1. Surgery):15-51. (In Russ.).
  9. Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WEE, Nicholson AG, Groome P, Mitchell A, Bolejack V, Ball D, et al. The IASLC Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Lung Cancer. J Thorac Oncol. 2016;11(1):39-51.  https://doi.org/10.1016/J.JTHO.2015.09.009
  10. Price TN, Nichols FC, Harmsen WS, Allen MS, Cassivi SD, Wigle DA, Shen KR, Deschamps C. A comprehensive review of anastomotic technique in 432 esophagectomies. Ann Thorac Surg. 2013;95(4):1154-1160; discussion 1160-1161. https://doi.org/10.1016/j.athoracsur.2012.11.045
  11. Seely AJ, Ivanovic J, Threader J, Al-Hussaini A, Al-Shehab D, Ramsay T, Gilbert S, Maziak DE, Shamji FM, Sundaresan RS. Systematic classification of morbidity and mortality after thoracic surgery. Ann Thorac Surg. 2010;90(3):936-942; discussion 942.  https://doi.org/10.1016/j.athoracsur.2010.05.014
  12. Doyle DJ, Hendrix JM, Garmon EH. American Society of Anesthesiologists Classification. 2023 Aug 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. 
  13. Larburu Etxaniz S, Gonzales Reyna J, Elorza Orúe JL, Asensio Gallego JI, Diez del Val I, Eizaguirre Letamendia E, Mar Medina B. Fístula cervical postesofagectomía: diagnóstico y tratamiento [Cervical anastomotic leak after esophagectomy: diagnosis and management]. Cir Esp. 2013;91(1):31-37. Spanish. https://doi.org/10.1016/j.ciresp.2012.09.005
  14. Markar S, Gronnier C, Duhamel A, Mabrut JY, Bail JP, Carrere N, Lefevre JH, Brigand C, Vaillant JC, Adham M, Msika S, Demartines N, Nakadi IE, Meunier B, Collet D, Mariette C; FREGAT (French Eso-Gastric Tumors) working group, FRENCH (Fédération de Recherche EN CHirurgie), and AFC (Association Française de Chirurgie). The Impact of Severe Anastomotic Leak on Long-term Survival and Cancer Recurrence After Surgical Resection for Esophageal Malignancy. Ann Surg. 2015;262(6):972-980.  https://doi.org/10.1097/SLA.0000000000001011
  15. Copeland GP, Jones D, Walters M. POSSUM: a scoring system for surgical audit. Br J Surg. 1991;78(3):355-360. 
  16. Huang C, Yao H, Huang Q, Lu H, Xu M, Wu J. A novel nomogram to predict the risk of anastomotic leakage in patients after oesophagectomy. BMC Surg. 2020;20(1):64.  https://doi.org/10.1186/s12893-020-00726-7
  17. Guthrie GJ, Charles KA, Roxburgh CS, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neutrophil-lymphocyte ratio: experience in patients with cancer. Crit Rev Oncol Hematol. 2013;88(1):218-230.  https://doi.org/10.1016/j.critrevonc.2013.03.010
  18. Maruyama Y, Inoue K, Mori K, Gorai K, Shimamoto R, Onitsuka T, Iguchi H, Okazaki M, Nakagawa M. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as predictors of wound healing failure in head and neck reconstruction. Acta Otolaryngol. 2017;137(1):106-110.  https://doi.org/10.1080/00016489.2016.1218047
  19. Oshi M, Kunisaki C, Miyamoto H, Kosaka T, Akiyama H, Endo I. Risk Factors for Anastomotic Leakage of Esophagojejunostomy after Laparoscopy-Assisted Total Gastrectomy for Gastric Cancer. Dig Surg. 2018;35(1):28-34.  https://doi.org/10.1159/000464357
  20. Jiao Y, Zhang X, Liu M, Sun Y, Ma Z, Gu X, Gu W, Zhu W. Systemic immune-inflammation index within the first postoperative hour as a predictor of severe postoperative complications in upper abdominal surgery: a retrospective single-center study. BMC Gastroenterol. 2022;22(1):403.  https://doi.org/10.1186/s12876-022-02482-9
Contact the author
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

Contact us
If you have any questions, complaints or suggestions, please use this feedback form.
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.
Submit Application

You can become an author of one of our magazines, send a request and we will consider it in during the day.

Name
Phone
E-mail
Message
Login
Registration
E-mail
Password
Forgot Password?

Log in to the site using your account in one of the services

Password recovery
E-mail
Login
Register

We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.