Personalized management of anastomotic leak after surgery for esophageal carcinoma.
OBJECTIVE
To summarize the management of anastomotic leak following surgery for esophageal carcinoma.


METHODS
The medical records of the patients developing digestive tract leak after surgery for esophageal carcinoma in our hospital from January 2003 to March 2011 were retrospectively analyzed.


RESULTS
A total of 36 patients were included, in whom 13 developed cervical anastomotic leak, 18 had intra-thoracic anastomotic leak, and 5 had intra-thoracic gastric necrosis. Of these patients, 7 were treated with resurgery, 6 with esophageal stent implantation, and 23 with conservative treatment. Treatment lasted for 5 to 181 days, averagely 47.0 +/- 31.9 days. After management, 9 patients died (25.0%). Among seven patients with resurgery, four had deceased, two were cured, and one developed leak again and was switched to conservative treatment until discharged. All the 6 patients treated with stent implantation were cured. Of the 24 patients receiving conservative treatment (including one switched from resurgery), 18 (75.0%) were cured and 1 was not cured but survived.


CONCLUSIONS
Anastomotic leak following surgery for esophageal carcinoma should be treated individually based on the onset time, location, size, and extent of the leakage. Conservative treatment is still a safe and effective method. The efficacy of stent implantation needs further investigation to confirm.
Department of Cardio-thoracic Surgery, Zhongshan Hospital of Sun Yat-sen University (Zhongshan People's Hospital), Zhongshan 528403, China.
Hong-Yu
HY
Ye
Wei-Zhao
WZ
Huang
Yin-Meng
YM
Wu
Yi
Y
Liang
Jun-Meng
JM
Zheng
Hai-Ming
HM
Jiang
D000328:Adult; D000368:Aged; D057868:Anastomotic Leak / Q000628:therapy*; D004938:Esophageal Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D057285:Precision Medicine; D016896:Treatment Outcome