[Esophago-digestive anastomosis dehiscence].
This paper aim is to discuss the main etiopathogenic aspects responsible for eso-digestive anastomotic leakage, as well as prophylactic and therapeutic measures of this postoperative complication. There were studied 173 consecutive eso-digestive anastomosis: 103 anastomosis performed for malignancy and 70 anastomosis for benign conditions. Surgical operations followed by an eso-digestive anastomosis were: esophageal reconstruction for benign esophageal caustic strictures (n=67); total gastrectomy (n=55); total esophagectomy (n=13); total esophagectomy plus total gastrectomy (one case); eso-gastrectomies (n=34); upper gastric pole resection (n=2); distal esophageal resection (n=1). Eso-digestive anastomosis topography were cervical (n=81), intrathoracic (n=37) and abdominal (n=57). There were 30 eso-gastrostomies, 81 eso-jejunostomies, and 62 eso-colostomies. There were recorded 24 eso-digestive anastomotic dehiscences (13.8%): 14 in the cervical region (17.2% out of 81 cervical anastomosis); 5 intrathoracic leakages (14.2% out of 35 anastomosis); 5 intraabdominal anastomotic dehiscences (8.7% out of 57 intraabdominal anastomosis). Four patients died as an anastomotic leakage consequence: two patients died after cervical eso-gastrostomy dehiscences, one patient died after an intrathoracic eso-jejunostomy leakage, and one patient died after intraabdominal eso-gastrostomy leakage. In conclusion, we analyze postoperative results, emphasizing the role of discovering and removal of predisposing factors which may lead to an eso-digestive anastomotic leakage.
Vasile
I
I
Clinica II Chirurgie, Spitalul Clinic Judeţean de Urgenţă Craiova, U.M.F Craiova. vasileion52@yahoo.com
Mirea
C
C
Vîlcea
I D
ID
Paşalega
M
M
Calotă
F
F
Meşină
C
C
Cheie
M
M
Dumitrescu
T
T
Mogoanţă
S
S
Tenea
T
T
Radu
V
V
Moraru
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D003106:Colon / Q000601:surgery*; D003125:Colostomy / Q000009:adverse effects; D013505:Digestive System Surgical Procedures / Q000379:methods; D004935:Esophageal Diseases / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects; D004943:Esophagogastric Junction / Q000601:surgery*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D006801:Humans; D007582:Jejunostomy / Q000009:adverse effects; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome