ASO Author Reflections: Risk of Benign Anastomotic Stricture Following Laparoscopic Gastric Ischemic Preconditioning Prior to Esophagectomy with Reconstruction

Benign anastomotic stricture is a frequently recognized complication following esophagectomy with reconstruction, with an incidence ranging from 10 to 56%.¹ These early strictures are most often related to anastomotic leak, scar contraction, or fistula formation, and are usually diagnosed approximately 3 months following esophagectomy.² To date, the majority of research regarding benign anastomotic stricture has focused on surgical technique at the time of esophagectomy. Laparoscopic gastric ischemic preconditioning (LGIP) prior to esophagectomy is a recently established technique that emerged as a way to reduce conduit morbidity. In response, our institution implemented a protocol employing universal LGIP prior to esophagectomy in all patients presenting with resectable esophageal cancer. In our initial analysis, we demonstrated a significant reduction in overall leak rate using LGIP prior to esophagectomy,³ however, at that time there was inadequate follow-up data to assess the long-term effects on stricture. …