Table 1.
Summary data of included studies investigating the association of arterial calcification and/or celiac trunk stenosis with anastomotic leakage after esophagectomy with gastric conduit reconstruction.
| Author/Country/ Year |
Type of Study (Time Period) |
Type of Surgery | Surgical Approach (Open/MIE †/Hybrid) |
Neoadjuvant Treatment (Total Number of Patients) |
AL § Rate (%) | Association of Arterial Calcification with AL (Trajectories) | Association of Celiac Trunk Stenosis with AL | Findings | Significance |
|---|---|---|---|---|---|---|---|---|---|
| Schröder/Germany/2002 [34] |
Prospective (NS) * |
Ivor Lewis (n = 15), McKeown (n = 7) and colon interposition (n = 1) | Open | 14 (23) | 21 | n/a | - | Celiac trunk stenosis was not associated with AL. | First study that investigated correlation of celiac artery stenosis and AL. |
| van Rossum/The Netherlands/2015 [35] | Retrospective (2003–2012) |
McKeown (n = 168) and transhiatal (n = 78) | Open (n = 42) MIE (n = 190) Hybrid (n = 14) |
134 (246) | 24 | + ± (aorta, right post-celiac arteries) | n/a | Calcifications of the aorta and the right post-celiac arteries were independently associated with AL. | First study that proposed a visual scoring system for arterial calcification, and demonstrated association of aortic calcification with AL. |
| Zhao/China/2016 [36] |
Retrospective (2010–2015) |
McKeown | Open (n = 264) MIE (n = 348) Hybrid (n = 97) |
80 (709) | 17.2 | + (aorta, celiac axis) | n/a | Calcifications of the aorta and the celiac axis were independently associated with AL. | Demonstrated that presence of calcification in the aorta or celiac artery are independent risk factors for AL in a Chinese population. |
| Goense/The Netherlands/2016 [37] |
Retrospective (2012–2015) |
Ivor Lewis | MIE | 153 (167) | 24 | + (aorta) | n/a | Calcifications of the aorta was independently associated with AL, while calcification of the celiac axis, left and right post-celiac arteries were not. | Demonstrated that presence of calcification on the aorta is an independent risk factor for AL. No significant association for calcification of other arteries. |
| Lainas/France/2017 [31] |
Retrospective (2004–2014) |
Ivor Lewis | Open (n = 239) Hybrid (n = 242) |
319 (481) | 17.4 | n/a | + | Celiac trunk stenosis was independently associated with gastric conduit necrosis. Also, AL occurred more often in patients with celiac trunk stenosis. | Investigated the correlation of celiac trunk stenosis (including extrinsic, caused by median arcuate ligament compression, and intrinsic, caused by calcifications) and gastric conduit necrosis. |
| Chang/Germany/ 2018 [38] |
Retrospective (2014) |
Ivor Lewis | Open and hybrid | n/a ‡ (164) | 8.5 | - # | + | Celiac trunk stenosis was associated with AL, while calcifications in the aorta, celiac axis, the left and right post-celiac arteries were not. | Found association of celiac trunk stenosis with AL, but no association of arterial calcifications and AL. |
| Borggreve/ The Netherlands/2018 [39] |
Retrospective (2003–2015) |
McKeown (n = 308) and transhiatal (n = 98) | Open (n = 80) MIE (n = 311) Hybrid (n = 15) |
275 (406) | 25.6 | + (supra-aortic arteries, coronary arteries) | n/a | Calcifications of the supra-aortic arteries and the coronary arteries were independently associated with AL. No significant association was found between the calcifications of the celiac axis or abdominal aorta, and AL. | Suggests that generalized cerebrovascular disease is a strong indicator for risk of AL. |
| Jefferies/United Kingdom/2019 [40] |
Retrospective 2006–2018) |
Ivor Lewis (n = 379) and McKeown (n = 34) | Open (n = 86) MIE (n = 103) Hybrid (n = 224) |
344 (413) | 15.8 | - | n/a | The presence of calcification at several sites including the celiac axis, post-celiac arteries, the proximal and distal aorta was studied, and no association with AL or gastric conduit necrosis was found. | No significant association between arterial calcification and AL or gastric conduit necrosis. |
| Brinkmann/ Germany/2019 [30] |
Prospective (2014) |
Ivor Lewis | Open (n = 17) Hybrid (n = 137) |
124 (154) | 9.7 | n/a | + | Celiac trunk stenosis was independently associated with AL. | Demonstrated that celiac trunk stenosis is an independent risk factor for AL. |
* NS, not specified. † MIE, minimally invasive esophagectomy. ‡ n/a, non-applicable/not available. § AL, anastomotic leakage. ± +, association was found. # -, no association was found.