title: Medical thoracoscopy and gastroscopy for the treatment of intrathoracic anastomotic leakage following esophagectomy.
abstract: Intrathoracic anastomotic leakage following esophagectomy is extremely difficult to manage appropriately. The outcomes of conservative management strategies are often disappointing, particularly in patients who develop adhesions of the pleural cavity and multiloculated empyema. This study describes a novel approach using combined thoracoscopy and gastroscopy in two cases. Thoracoscopy under local anesthesia was used to dissect the septations within the multiloculated empyema and remove the infected focus by direct visualization, and gastroscopy was subsequently performed to place a nasogastric or sump tube around the leak. The outcomes of both procedures were satisfactory: the empyemas almost completely resolved, the anastomotic leak closed quickly and there was adequate lung re-expansion. Accordingly, the combination of thoracoscopy and gastroscopy for the treatment of intrathoracic anastomotic leak post-esophagectomy may be an effective, safe, minimally-invasive, simple and inexpensive procedure.
authors.affiliation: Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Guangzhou, Guangdong 510060; ; Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong 510405,  P.R. China.
authors.forename: Xiao-Hai
authors.initials: XH
authors.lastname: Li
authors.forename: Yi
authors.initials: Y
authors.lastname: Hu
authors.forename: Tie-Hua
authors.initials: TH
authors.lastname: Rong
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Li
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Su
authors.forename: Hong
authors.initials: H
authors.lastname: Yang
authors.forename: Amos Ela
authors.initials: AE
authors.lastname: Bella
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Fu