Sina Ercan, MD, Thomas W. Rice, MD, Sudish C. Murthy, MD, PhD, Lisa A

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Does esophagogastric anastomotic technique influence the outcome of patients with esophageal cancer? Sina Ercan, MD, Thomas W. Rice, MD, Sudish C. Murthy, MD, PhD, Lisa A. Rybicki, MS, Eugene H. Blackstone, MD The Journal of Thoracic and Cardiovascular Surgery Volume 129, Issue 3, Pages 623-631 (March 2005) DOI: 10.1016/j.jtcvs.2004.08.024 Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Modified Collard cervical esophagogastric anastomotic technique (see Electronic Video). A, With apposition of the posterior walls of the esophagus and stomach, an endoscopic linear cutting stapler is applied to construct the posterior wall of the anastomosis. The anvil is placed in the esophagus, and the staple cartridge is placed in the stomach. B, The anterior wall is constructed with a running suture. Transverse closure allows maximal distraction of the stapled ends of the posterior wall. The arrow shows the anastomotic lumen. Reprinted with the permission of The Cleveland Clinic Foundation. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 623-631DOI: (10.1016/j.jtcvs.2004.08.024) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Freedom from cervical wound infection. Each symbol represents an event among patients receiving the modified Collard cervical esophagogastric anastomosis (stapled, open circles) or hand-sewn anastomosis (sewn, open squares). Vertical bars are asymmetric nonparametric confidence limits equivalent to 1 SE. Numbers in parentheses are patients remaining at risk. Solid lines are parametric estimates and are enclosed within asymmetric confidence limits equivalent to 1 SE. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 623-631DOI: (10.1016/j.jtcvs.2004.08.024) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Instantaneous risk (hazard function) of cervical wound infection. Dashed lines represent asymmetric confidence limits equivalent to 1 SE. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 623-631DOI: (10.1016/j.jtcvs.2004.08.024) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Instantaneous risk of cervical anastomotic leak. Depiction is as in Figure 3. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 623-631DOI: (10.1016/j.jtcvs.2004.08.024) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Instantaneous risk of anastomotic dilatation. Depiction is as in Figure 3. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 623-631DOI: (10.1016/j.jtcvs.2004.08.024) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Cumulative number of anastomotic dilatations. This repeated-events depiction presents the average number of dilatations per patient.6 Otherwise, the format is as in Figure 2. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 623-631DOI: (10.1016/j.jtcvs.2004.08.024) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Electronic Figure 1 Freedom from cervical anastomotic leak. Depiction is as in Figure 2. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 623-631DOI: (10.1016/j.jtcvs.2004.08.024) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Electronic Figure 2 Freedom from anastomotic dilatation. Depiction is as in Figure 2. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 623-631DOI: (10.1016/j.jtcvs.2004.08.024) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Electronic Figure 3 Instantaneous risk of dilatation. This repeated-events depiction presents number of dilatations per patient per month. Depiction is as in Figure 3. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 623-631DOI: (10.1016/j.jtcvs.2004.08.024) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Electronic Figure 4 Survival. Depiction is as in Figure 2. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 623-631DOI: (10.1016/j.jtcvs.2004.08.024) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Electronic Figure 5 Instantaneous risk of death. Depiction is as in Figure 2. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 623-631DOI: (10.1016/j.jtcvs.2004.08.024) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions