Esophageal Cancer Surgery: Experiences With Anastomotic Leak Treatments At A High-Volume Center

To study treatments and interventions for anastomotic leak following esophagectomy at a high volume center.Anastomotic leak is a severe and common complication of esophagectomies. Anastomotic leak patients treated between Jan 1 2016 and Dec 31 2018 were retrospectively identified from an institutional database of patients undergoing esophagectomies and were further analyzed. The primary out- comes for the assessed interventions were success- rate of intervention and length-of-stay. The following anastomotic leak treatments were assessed by this study: Conservative treatment, esophageal stents, endoscopic vacuum assisted closure therapy (E-VAC) and surgically placed drains.The study population consisted of 223 patients, 28 (12.6\ of who suffered anastomotic leaks. The distribution of the interventions and conservative treatment is illustrated in Figure 1. The success-rate of E-VAC was 75.0\n=8), compared to a rate of 25.0\n=4) and 59.1\n=13). Surgically placed drains had a success-rate of 100.0\ but were only performed on 3 patients in total.E-VAC was the most effective non- surgical leak intervention in terms of success-rate. Due to the design of this study, the effectiveness of conservative treatment was likely under- estimated.Figure 1