Intraoperative quantitative blood flow measurement significantly reduces anastomotic leakage in esophageal cancer surgery.

• Patients using SPY-QP imaging had lower overall complication rates and less postoperative leakage.
• They experienced a shorter hospital stay and less intraoperative blood loss.

Quantitative assessment helps optimize anastomotic site selection, improving patient outcomes.

• The quantitative group had more preoperative chemotherapy and specific anastomotic techniques, enhancing results.