Austrian Society of Surgical Oncology consensus paper on the classification and treatment of anastomotic leaks after esophageal resections

Summary Background Anastomotic leakage is still the most frequent cause of postoperative mortality following gastroesophageal surgery. This consensus paper contains the first classification and treatment recommendations from the Austrian Society of Surgical Oncology (ACO ASSO) for specialists treating patients with anastomotic leakage after esophageal resections. Methods The Board of Directors of the ACO ASSO identified classification and treatment recommendations for anastomotic leakage after esophageal resections as an important topic for study and invited experts to participate in the drafting of a consensus paper. This panel of experts was tasked with determining an outline, reviewing the relevant literature, and preparing a written document with a recommendation on the classification and treatment of anastomotic leaks after esophageal resections. In order to reach a consensus on the classification of anastomotic leakage, the expert panel invited all members of the ACO ASSO upper gastrointestinal tract working group to take part in a survey to determine which classification they would prefer. The paper was written based on the results of the survey and the research of the expert panel. Results The majority of the ACO ASSO upper gastrointestinal tract working group members surveyed chose the German CAES ( Chirurgische Arbeitsgemeinschaft für Endoskopie und Sonographie ) classification as the one they would prefer in their daily practice. Based on this, the respective treatment recommendations were created in alignment with clinical decision-making by linking each grade of insufficiency to recommended interventions. Conclusion With this consensus paper, the ACO ASSO has created a clear guideline for current treatment and a recommendation for the classification of anastomotic leaks after esophageal resections. This will help to streamline treatment protocols and improve clarity in clinical documentation and research.