title: [Application of trans-abdominal-mediastinal drainage tube in patients with high risk of esophagogastric or esophago-jejunal anastomotic leakage].
abstract: OBJECTIVE
  To evaluate the therapeutic effects of trans-abdominal-mediastinal drainage tube on the prevention of esophagogastric or esophago-jejunal anastomotic leakage.
  
  
  METHODS
  A total of 79 patients underwent thoraco-abdominal radical resection for gastric cardia cancer, with high risk of leakage of the anatsomosis, from Aug. 2007 to Aug. 2011 were included in this study. They were assigned into 2 groups. Forty one patients had trans-abdominal-mediastinal drainage tube (improvement group) and 38 patients were without the mediastinal drainage tube (control group). The clinical data of all the 79 patients were reviewed and the therapeutic effects of the two treatment approaches were compared.
  
  
  RESULTS
  There was anastomotic leakage in four patients of the improvement group. They were with stable vital signs and the median hospital stay was 29.3 days. There was anastomotic leakage in five cases of the contol group and all of them had high fever and chest tightness. One among those five patients had transdermal placement of thoracic drainage tube and was cured, and four among those five patients had second debridement operation, with 3 cured and one death case. Except the one death case, the median hospital stay of the control group was 53.4 days, significantly longer than that of the improvement group (P < 0.05).
  
  
  CONCLUSIONS
  Although putting trans-abdominal-mediastinal drainage tube can not prevent the leakage of esophagogastric or esophago-jejunnal anastomosis, it can reduce the systemic inflammatory responses, death and painful suffering of the patients caused by anastomotic leakage.
authors.affiliation: Department of General Surgery, Affiliated Tumor Hospital of Zhengzhou University, Henan Tumor Hospital, Zhengzhou 450008, China.
authors.forename: Gang-cheng
authors.initials: GC
authors.lastname: Wang
authors.forename: Guang-sen
authors.initials: GS
authors.lastname: Han
authors.forename: Ying-kun
authors.initials: YK
authors.lastname: Ren
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D057868:Anastomotic Leak / Q000209:etiology / Q000517:prevention & control*; D002299:Cardia; D004322:Drainage / Q000379:methods*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000601:surgery*; D013274:Stomach Neoplasms / Q000601:surgery