Introduction: The symptoms of anastomotic leak often appear only at a late stage or are nonspecific, with many different diagnoses and treatments available with no clear consensus on the underlying mechanisms. The purpose of this review is to provide a brief summary of the existing literature on the definition and classification of thoracic esophagectomy anastomotic leak, its importance and prevalence, as well as the different risk factors, diagnoses and treatments.

Material and Methods: Scopus and PubMed electronic databases were searched to identify articles published between 1995 and 2022 on AL after esophagectomy. Terms used include: “anastomotic leak,” “esophageal cancer,” “cervical,” “intrathoracic,” “diagnosis,” “management,” “risk factor,” combined with Boolean “OR” function study Frequent references for further research and related publications are searched. There is limited English language.

Results: Anastomotic leak is one of the most common complications after esophagectomy and is associated with increased morbidity and mortality. Many projects range from small studies to large collaborations aimed at identifying potential preoperative and perioperative risks and improving diagnostic and management procedures. Despite the increase in available data, many aspects of anastomotic leak remain problematic and no general guidelines exist.

Conclusion: AL after esophagectomy has many causes, is complex, and can have serious complications that will later affect the outcome. Current treatment is based on an individualized approach and reliable international evidence will help improve the prevention and treatment of AL. Treatment and patient outcomes. Higher quality evidence for such guidelines is urgently needed. The introduction of the ECCG system is a first priority to provide an up-to-date international standard for comparing the results of treatment strategies.