Development and internal validation of a prediction model for early anastomotic leak after minimally invasive esophagectomy: a prospective cohort study

Associations with ECCG-defined AL severity were also assessed.</p> <p>Gastric conduit ischemic length ≥3.5 cm (OR 3.361, <i>p</i> = 0.043) and postoperative serum albumin <31.75 g/L (OR 0.886, <i>p</i> < 0.001) were independent predictors. The Lasso LR model achieved an internal validation AUC of 0.727 (95% CI: 0.641–0.810). The risk-stratification system yielded AL rates of 11.00%, 22.73%, and 73.68% across low-, medium-, and high-risk groups (<i>p</i> < 0.001).

Both predictors correlated with ECCG severity. A nomogram and web-based calculators were developed for bedside use.</p> <p>Quantitative gastric conduit ischemic length and postoperative serum albumin enabled individualized AL risk assessment within 72 h after MIE. By integrating local perfusion and systemic healing capacity, the model and digital tools provide a framework for early targeted postoperative management.</p> <p>Chinese Clinical Trial Registry, ChiCTR2100054550.

Registered December 19, 2021, <a target="_blank" href="chictr.org.cn/">https://www.chictr.org.cn/</a>.</p>