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Comment & Response
December 11, 2019

Routine Esophagram for Detecting Anastomotic Leak After Esophagectomy—Reply

Author Affiliations
  • 1Division of Gastrointestinal and Minimally Invasive Surgery, The Oregon Clinic, Portland
  • 2Division of Gastrointestinal and General Surgery, Department of Surgery, Oregon Health and Science University, Portland
JAMA Surg. 2020;155(3):266-267. doi:10.1001/jamasurg.2019.4944

In Reply We greatly appreciate the consideration and comments from the group at McGill University regarding our study,1 as well as their own published contribution to this topic2 in which they have shown very little value of routine esophagram to the clinical management of anastomotic leaks after esophagectomy. We are in agreement that most routine esophagrams are negative studies and that the low sensitivity of the test is a major limitation. As pointed out, its role in enhanced recovery pathway approaches will also need to be better defined. We recognize that there are many respected institutions, including our colleagues at McGill University, that have abandoned the use of routine esophagram altogether for the exact reasons listed in Cools-Lartigue and Ferri’s thoughtful letter.

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