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Digital subtraction angiography-guided esophagography, intraluminal drainage, and endoscopic clipping–complex managements for intrathoracic esophagogastric anastomotic leak
Ist Teil von
The Journal of surgical research, 2016-07, Vol.204 (1), p.68-74
Ort / Verlag
United States: Elsevier Inc
Erscheinungsjahr
2016
Quelle
MEDLINE
Beschreibungen/Notizen
Abstract Background Intrathoracic esophagogastric anastomotic leak is a critical complication after esophagectomy. Recently, novel complex diagnostic and therapeutic managements for intrathoracic esophagogastric anastomotic leak have been performed at our institution. Materials and methods Sixty-seven consecutive patients with intrathoracic esophagogastric anastomotic leak after esophagectomy from January 2009 to May 2015 at our institution were reviewed. Thirty-nine patients received conventional managements (conventional group), in which they were diagnosed via contrast swallow when there was a suspicion of anastomotic leak and were subsequently treated with a metallic stent. Twenty-eight patients received complex managements (complex group), in which they were diagnosed using digital subtraction angiography, an intraluminal drainage tube was placed, and clips were subsequently performed under an endoscope. The outcomes of the two groups were retrospectively analyzed. Results There were no significant differences ( P > 0.05) between the two groups in the preoperative general clinical data, whereas the postoperative data exhibited some differences. Compared with the conventional group, the confirmation time and recovery time are significantly decreased in the complex group ( P < 0.01 and P < 0.01, respectively), and the incidence of severe complications is also lower ( P < 0.01); however, there were no significant differences in the mortality rate between the two groups ( P > 0.05). Conclusions Complex managements may represent a useful therapeutic option for postoperative esophagogastric anastomotic leak.