Using explainable AI, we can significantly improve predictions for 90-day mortality and anastomotic leakage after oesophagectomy.

• The 90-day mortality rate was 6.0%, with anastomotic leakage at 12.4%.
• Explainable AI achieved an AUC of 0.95 for predicting mortality, compared to 0.88 for traditional methods.

This technology allows for personalized risk assessments, improving decision-making for surgical candidates.

• Significant predictors included age, ASA class, BMI, and perioperative bleeding, with all factors showing nonlinear relationships.