Conservative management of esophageal leaks by transluminal endoscopic drainage of the mediastinum or pleural space.
BACKGROUND
The management of postoperative leaks into the mediastinum or pleural cavities after esophageal surgery yields unsatisfactory results. A recently described method, drainage of the mediastinum or pleural cavity through suture line defects, has been used in our department with eight patients.


METHODS
A suction tube was advanced over an endoscopically placed guide wire into the abscess from inside the esophagus, and gentle aspiration was used to remove saliva and secretions. Intravenous antibiotics and total parenteral nutrition were also given.


RESULTS
The sepsis was rapidly controlled, and the abscess cavity progressively collapsed in all cases. Seven patients recovered and were discharged 34 to 61 days after operation; one died of concomitant complications.


CONCLUSIONS
This method seems promising for the management of intrathoracic esophageal leaks.
Infante
M
M
Valente
M
M
Andreani
S
S
Catanese
C
C
Dal Fante
M
M
Pizzetti
P
P
Giudice
G
G
Basilico
M
M
Spinelli
P
P
Ravasi
G
G
D000368:Aged; D004322:Drainage / Q000379:methods*; D004945:Esophagoscopy; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D010994:Pleura; D013529:Surgical Wound Dehiscence / Q000628:therapy*