Title: Risk factors for refractory enterocutaneous fistula following button jejunostomy removal
and its treatment using a novel extraperitoneal approach in patients with oesophageal cancer:
A retrospective cohort study
Version: 1 Date: 01 Sep 2022
Reviewer:  Shen Yang
Reviewer's report:
This is an interesting study investigating the risk factors for refractory enterocutaneous fistula
following button jejunostomy removal and reported its treatment using a novel extraperitoneal
approach in patients with esophageal cancer. They concluded that duration>12 months for button
jejunostomy removal and fistula<15.0 mm are the independent risk factors for REF after button
jejunostomy removal. EPA for REF closure is a novel, simple, and useful surgical option for
patients with REF after esophagectomy. The manuscript was well written and its conclusion
could guide clinical operation.
However, there are some major concerns:
1. All patients received button jejunostomy in esophagectomy for esophageal cancer between
March 2013 and October 2021? Select indications for button jejunostomy in esophagectomy for
esophageal cancer?
2. The sample size of single center in this study is too small, and the reliability of statistical
analysis results is poor. Therefore, a large sample size of multi-center is needed for verification.
Title: Risk factors for refractory enterocutaneous fistula following button jejunostomy removal
and its treatment using a novel extraperitoneal approach in patients with oesophageal cancer:
A retrospective cohort study
Version: 1 Date: 01 Sep 2022
Reviewer:  Shen Yang
Reviewer's report:
This is an interesting study investigating the risk factors for refractory enterocutaneous fistula
following button jejunostomy removal and reported its treatment using a novel extraperitoneal
approach in patients with esophageal cancer. They concluded that duration>12 months for button
jejunostomy removal and fistula<15.0 mm are the independent risk factors for REF after button
jejunostomy removal. EPA for REF closure is a novel, simple, and useful surgical option for
patients with REF after esophagectomy. The manuscript was well written and its conclusion
could guide clinical operation.
However, there are some major concerns:
1. All patients received button jejunostomy in esophagectomy for esophageal cancer between
March 2013 and October 2021? Select indications for button jejunostomy in esophagectomy for
esophageal cancer?
2. The sample size of single center in this study is too small, and the reliability of statistical
analysis results is poor. Therefore, a large sample size of multi-center is needed for verification.
Please review this paper.
user
Title: Risk factors for refractory enterocutaneous fistula following button jejunostomy removal
and its treatment using a novel extraperitoneal approach in patients with oesophageal cancer:
A retrospective cohort study
Version: 1 Date: 01 Sep 2022
Reviewer:  Shen Yang
Reviewer's report:
This is an interesting study investigating the risk factors for refractory enterocutaneous fistula
following button jejunostomy removal and reported its treatment using a novel extraperitoneal
approach in patients with esophageal cancer. They concluded that duration>12 months for button
jejunostomy removal and fistula<15.0 mm are the independent risk factors for REF after button
jejunostomy removal. EPA for REF closure is a novel, simple, and useful surgical option for
patients with REF after esophagectomy. The manuscript was well written and its conclusion
could guide clinical operation.
However, there are some major concerns:
1. All patients received button jejunostomy in esophagectomy for esophageal cancer between
March 2013 and October 2021? Select indications for button jejunostomy in esophagectomy for
esophageal cancer?
2. The sample size of single center in this study is too small, and the reliability of statistical
analysis results is poor. Therefore, a large sample size of multi-center is needed for verification.
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