Methylene Blue vs Oral Water-soluble Contrast in Detecting Cervical Anastomotic Leak after Esophagectomy for Cancer Esophagus: A Comparative Study

Background: Cervical anastomotic leaks (CALs) are significant complications following esophagectomy for esophageal cancer, leading to morbidity and prolonged hospital stays. Accurate and timely detection is critical to mitigate adverse outcomes. Objective: This study aims to compare the diagnostic accuracy, sensitivity, and specificity of oral water-soluble contrast (OWSC) and methylene blue (MB) in detecting CALs post-esophagectomy. Materials and methods: A single-center retrospective study was conducted on 692 patients with esophageal cancer who underwent transhiatal esophagectomy (THE) over 15 years. Patients underwent MB dye testing on the 7th postoperative day, followed by a Conray esophagogram on the 8th day. Leak classifications and outcomes were analyzed, and diagnostic accuracy, sensitivity, and specificity of both modalities were calculated. Results: = 0.0047). Conclusion: Methylene blue dye testing is a reliable, cost-effective, and statistically better bedside diagnostic tool for detecting CALs, especially in resource-limited settings. If the MB test is negative and there is a high clinical suspicion of leak, only then should further investigations, like a Conray esophagogram, be done. How to cite this article: . Methylene Blue vs Oral Water-soluble Contrast in Detecting Cervical Anastomotic Leak after Esophagectomy for Cancer Esophagus: A comparative study. Euroasian J Hepato-Gastroenterol 2025;15(2):123-126.