title: Management of esophageal perforation and anastomotic leak by transluminal drainage.
abstract: BACKGROUND
  The management of esophageal perforations and leaks remains a challenge. Although there are broad management principles, each situation may require a different surgical approach. The aim of this report was to describe the management of these esophageal crises by transluminal drainage via a transabdominal approach.
  
  
  METHODS
  Between 2005 and 2009, patients with anastomotic or gastric staple line leak (n = 4) or esophageal perforation (n = 2) underwent transabdominal surgery and transluminal drainage. This simple technique has, to the best of our knowledge, not been previously reported.
  
  
  RESULTS
  All six patients survived. The median intensive care unit and hospital stays were 12 days (range 0-32) and 63 days (range 32-99), respectively. At a median follow-up time of 25 months (range 15-60), five of the six patients remain alive and well. One patient with node positive esophageal carcinoma has died from relapsed disease.
  
  
  CONCLUSIONS
  Transabdominal transluminal drainage should be added to the list of potential techniques that can be employed in management of esophageal leaks and perforations. It is a valuable adjunct to the armamentarium of the esophageal surgeon for dealing with these challenging situations.
authors.affiliation: Department of Surgery, University Hospitals of Leicester NHS Trust, Level 6 Balmoral Building, Leicester Royal Infirmary, Infirmary Square, Leicester, LE1 5WW, UK.
authors.forename: Robert N
authors.initials: RN
authors.lastname: Williams
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Hall
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Sutton
authors.forename: Sukhbir S
authors.initials: SS
authors.lastname: Ubhi
authors.forename: David J
authors.initials: DJ
authors.lastname: Bowrey
mesh_terms: D000368:Aged; D057868:Anastomotic Leak / Q000209:etiology / Q000628:therapy*; D004322:Drainage / Q000379:methods*; D004939:Esophageal Perforation / Q000209:etiology / Q000628:therapy*; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome