The risk factors of esophagogastric anastomotic leak in the perioperative period include malnutrition, smoking, steroid use, bowel preparation, chemotherapy, duration of surgery, vasopressor drugs use, intravenous fluid administration, blood transfusion and surgical anastomotic technique, which can be reduced with the improvement of surgeons' ability to identify the high-risk patients. This article summarizes the specific measures for these risk factors: preoperative nutritional support for 5–7 d for malnourished patients, full intestinal preparation, perioperative smoking cessation, limitation of steroids and vasopressors drug applications, avoidance of early operations (<4 weeks) following chemotherapy, and the goal-directed fluid management.
