Anatomical and anastomotic viability indexes for stratifying the risk of anastomotic leakage in esophagectomy with retrosternal reconstruction

Background Risk prediction of anastomotic leakage using anatomical and vascular factors has not been well established. This study aimed to assess the affecting hemodynamics gastric conduit develop a novel risk stratification system in patients undergoing esophagectomy with retrosternal reconstruction. Methods retrospective cohort analyzed 202 esophageal cancer who underwent subtotal tube reconstruction between January 2008 December 2020. for (AL), including index (AI) viability (AVI), were evaluated logistic regression model. Results According model, independent AL preoperative body mass ≥23.6 kg/m2 (odds ratio [OR], 7.97; 95% confidence interval [CI], 2.44–26.00; P < 0.01), AI <1.4 (OR, 23.90; CI, 5.02–114.00; AVI <0.62 8.02; 2.57–25.00; 0.01). The stratified into four groups as follows: low-risk group (AI ≥1.4, ≥0.62 [2/99, 2.0%]), intermediate [2/29, 6.9%]), high-risk <1.4, [8/53, 15.1%]), [11/21, 52.4%]). Conclusion combination strongly predicted AL. Additionally, use enabled