Prospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2019; 11(11): 407-413
Published online Nov 27, 2019. doi: 10.4240/wjgs.v11.i11.407
Incidence of anastomotic stricture after Ivor-Lewis oesophagectomy using a circular stapling device
Robert Tyler, Amit Nair, Meagan Lau, James Hodson, Rizwan Mahmood, Jan Dmitrewski
Robert Tyler, Amit Nair, Meagan Lau, Jan Dmitrewski, Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TH, United Kingdom
James Hodson, Institute of Translational Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TH, United Kingdom
Rizwan Mahmood, Department of Gastroenterology, Russells Hall Hospital, Dudley DY1 2HQ, United Kingdom
Author contributions: Tyler R, Nair A and Dmitrewski J designed the research; Tyler R, Nair A, Lau M and Mahmood R performed the research; Tyler R and Hodson J analysed the data; Tyler R and Dmitrewski J wrote the manuscript; all authors critically reviewed and approved the manuscript.
Institutional review board statement: The study was registered No. CARMS 15403- with University Hospitals Birmingham Clinical Audit Registration and Management System (CARMS), who granted ethical approval.
Informed consent statement: Local ethical review was obtained and confirmed that no consent was needed due to the non-interventional nature of the study.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Robert Tyler, MBChB, Surgeon, Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham B15 2TH, United Kingdom. robert.tyler@nhs.net
Telephone: +44-12-13715883 Fax: +44-12-13715896
Received: May 18, 2019
Peer-review started: May 20, 2019
First decision: August 2, 2019
Revised: October 16, 2019
Accepted: November 4, 2019
Article in press: November 4, 2019
Published online: November 27, 2019
Processing time: 192 Days and 22 Hours
Core Tip

Core tip: Heavy debate exists on anastomotic technique at oesophagectomy to reduce the incidence of post-operative stricture. This study would represent the largest published series of circular stapled intrathoracic anastomoses to look at stricture rates. It finds a 10% stricture rate in 154 patients, with a median time to stricture of 99 d. It highlights that this technique gives an acceptable stricture rate when compared with other techniques. Furthermore, it stresses the importance of close clinical follow-up in the first six months to avoid missing this highly morbid complication and encourages open access clinic appointments for patients with early symptoms of dysphagia.