The incidence of anastomotic leakage after esophagectomy remains around 10%. It was previously reported that PDSII rapidly loses tensile strength at pH 1.0 and pH 8.5. By contrast, LACLON degradation is reportedly insensitive to pH. We therefore compared LACLON with PDSII for esophago-gastric conduit, layer-to-layer, handsewn anastomosis. Between January 2016 and January 2020, 90 patients who received posterior mediastinal gastric conduit reconstruction with layer-to-layer handsewn anastomosis (51 using PDSII and 39 using LACLON) at Akita University Hospital were enrolled. The incidence of anastomotic leakage was significantly lower in the LACLON (2.6%, 1/39 patients) than PDSII group (15.7%, 8/51 patients) (p = 0.0268). Multivariable logistic analysis showed the risk of anastomotic leakage was significantly greater with PDSII than LACLON (odds ratio 11.01; 95% CI 1.326–277.64; p = 0.024). The percentages of time the pH was higher than 8 on the gastric conduit side of the anastomosis were 3.1%, 5.7%, 20.9% and 80.5%, respectively, in the four most recent patients. The present study showed that pH at the anastomosis soon after esophagectomy tends to be alkaline rather than acidic, which raises the possibility that this alkalinity facilitates the deterioration of surgical sutures including PDSII.

食管切除术后吻合口漏的发生率保持在10%左右。之前有报道称，PDSII 在 pH 1.0 和 pH 8.5 时会迅速失去拉伸强度。相比之下，据报道 LACLON 降解对 pH 值不敏感。因此，我们将 LACLON 与 PDSII 进行了食管-胃导管层对层手工缝合吻合术的比较。2016 年 1 月至 2020 年 1 月期间，在秋田大学医院接受了 90 名接受后纵隔胃导管重建和层间手工缝合吻合术的患者（51 名使用 PDSII，39 名使用 LACLON）。LACLON 的吻合口漏发生率（2.6%，1/39 患者）显着低于 PDSII 组（15.7%，8/51 患者）（p = 0.0268）。多变量逻辑分析显示，PDSII 的吻合口漏风险显着高于 LACLON（优势比 11.01；95% CI 1.326-277.64；p = 0.024）。在最近的四名患者中，吻合口胃管侧 pH 值高于 8 的时间百分比分别为 3.1%、5.7%、20.9% 和 80.5%。目前的研究表明，食管切除术后不久吻合口的 pH 值趋于碱性而不是酸性，这增加了这种碱性促进手术缝合线（包括 PDSII）恶化的可能性。