The Incidence and Early Outcomes of Cervical Esophagogastric Anastomotic Leaks Following Oncologic Esophagectomy at Kenyatta National Hospital

Abstract

Background: Oncologic Esophagectomy is a cornerstone in the management of resectable esophageal cancer, with postoperative anastomotic leaks a common complication. Few studies have looked specifically at the mortality and morbidity associated with cervical esophagogastric anastomotic leaks as a complication of oncologic esophagectomy. Study Objective: To describe the incidence and early outcomes of cervical esophago-gastric anastomotic leak among patients undergoing oncologic esophagectomy at Kenyatta National Hospital. Methodology: A 7 year retrospective cohort study of 205 patients who underwent oncologic esophagectomy, with a cervical esophago-gastric anastomosis at KNH between January 2014 and December 2021was performed. Data was collected via consecutive sampling of all patients who underwent oncologic esophagectomy;of particular interest was whether they developed an anastomotic leak and its associated complications such as mortality, length of hospital stay, time to oral intake and need for surgical intervention. Results : Out of 205 patients who underwent esophagectomy, 41 developed CEGAL giving an incidence of 20% with only 12%(n=5 ) requiring surgical intervention. The overall mortality rate was 5.85%(n=12 ). There was an association between presence of CEGAL and length of hospital stay (p<0.0001) and delayed resumption of oral feeding (p<0.0001). However there was no association between CEGAL and increased risk of mortality (p=0.118). Conclusion: The presence of CEGAL increases length of hospital stay and the duration to resumption of oral feeds, with no significant effect on hospital mortality.