Evaluation of used treatment modalities in patients with anastomotic leak following esophagectomy

Emil Ainsworth Jochumsen, Michael Hareskov Larsen, Alan Patrick Ainsworth*

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Background: Anastomotic leak is a known and severe complication following esophagectomy. This study evaluates different interventions for treating this complication. Material and Methods: Anastomotic leak patients treated between January 1, 2016 and December 31, 2018 were retrospectively analyzed from an institutional database of patients undergoing esophagectomy. The primary out-comes for the assessed interventions were success-rate of intervention and length-of-stay (LOS). Results: The study population consisted of 223 patients, 28 (12.6%) of whom were diagnosed with anastomotic leak. Eighteen of the 28 anastomotic leaks were diagnosed by oral contrast CT scan and 10 endoscopically. Thirteen leaks were type I (no change in therapy), 12 were type II (interventional, but not surgical treatment) and 3 were type III (surgical treatment). The median postoperative day of leak diagnosis was day 5 (range 1 - 11 days). The median LOS for patients with type I leak was 9 days (range 3-51 days). Endoscopic vacuum assisted closure therapy (E-VAC) (n=8) had a success-rate of 75 %, esophageal stents (n=4) 25 %, surgically placed drains (n=3) 100 % (not significant). Median LOS for E-VAC was 38 days (range 18-74 days), for stent 56 days (range 15-66 days) and for surgical drains 34 days (range 32-45 days) (not significant). Conclusion: There was no statistical significant difference in success rate between the different treatment modalities in the treatment of anastomotic leaks following esophagectomy. In patients with small leaks and few systemic complications, conservative treatment is often possible.

Original languageEnglish
JournalSurgical Chronicles
Volume25
Issue number4
Pages (from-to)295-298
ISSN1108-5002
Publication statusPublished - Oct 2020

Bibliographical note

Publisher Copyright:
© 2020 Surgical Society of Northern Greece. All rights reserved.

Keywords

  • Anastomotic leak
  • Complications
  • Esophagectomy
  • Treatment modalities

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