Work

Best evidence for the prevention and management of anastomotic fistula after esophagectomy in patients with esophageal cancer

Year: 2026

Type: article

Abstract: Objectives: Anastomotic fistula is a common complication in patients with esophageal cancer following surgery. It leads to delayed healing, malnutrition, reduced quality of life, and increased patient pain and medical costs. Preventing anastomotic fistula can significantly enhance patients' quality of life. This study aimed to summarize the best evidence for the prevention and management of anastomotic fistula after esophagectomy in patients with esophageal cancer, providing a reference for clinical nursing practice. Methods: Following the '6S' evidence resource model, evidence retrieval was conducted from the top-down, collecting clinical practice guidelines, systematic evaluations, meta-analyses, and expert consensus. The retrieval period spanned from database inception to February 2026. Two reviewers independently screened and assessed the literature, subsequently extracting and summarizing the evidence according to the JBI system for grading evidence and recommendations. Results: A total of 11 articles were included: 3 guidelines, 6 systematic reviews, and 2 randomized controlled trials. A total of 19 best evidence were identified for the prevention and management of anastomotic fistula in postoperative patients with esophageal cancer. These pieces of evidence encompass key areas including monitoring and evaluation, fistula care, pipeline care, respiratory tract management, psychological care, nutrition management, drug management, complication management, and health education. Conclusions: This study summarized the best evidence for the prevention and management of anastomotic fistula after esophagectomy in patients with esophageal cancer, providing a reference for clinical nursing practice. The application of evidence should be tailored according to the department's clinical condition and individual patient circumstances. Systematic review registration: This study was registered at the Fudan University Centre for Evidence-based Nursing (Registration No. ES20244220).

Source: Asia-Pacific Journal of Oncology Nursing

DOI: 10.1016/j.apjon.2026.100925

Authors: Qunhong Liu, Xinru Chen, Yutong Hong, Dandan Liu

Institutions: Sun Yat-sen University, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China

Language: English

Topic: Esophageal Cancer Research and Treatment

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,980