title: The Diagnostic Value of Routine Contrast Esophagram in Anastomotic Leaks After Esophagectomy.
abstract: Routine contrast esophagram has been shown to be increasingly limited in diagnosing anastomotic leaks after esophagectomy.
  
  
  
  Patients undergoing esophagectomy from 2013 to 2014 at Huai'an First Peoples' Hospital were identified. We retrospectively analyzed patients who underwent routine contrast esophagram on postoperative day 7 (range 6-10) to preclude anastomotic leaks after esophagectomy.
  
  
  
  In 846 patients who underwent esophagectomy, a cervical anastomosis was performed in 286 patients and an intrathoracic anastomosis in 560 patients. There were 57 (6.73%) cases with anastomotic leaks, including cervical leaks in 36 and intrathoracic leaks in 21 patients. In the cervical anastomotic leak patients, 13 were diagnosed by early local clinical symptoms and 23 underwent routine contrast esophagram. There were 7 (30.4%) true-positive, 11 (47.8%) false-negative, and five (21.8%) equivocal cases. In the intrathoracic anastomotic leak patients, four (19%) were diagnosed by clinical symptoms, 16 (76.2%) were true positives, and one (4.8%) was a false negative. Aspiration occurred in five patients with cervical anastomoses and in eight patients with intrathoracic anastomoses; aspiration pneumonitis did not occur in these cases.
  
  
  
  Gastrografin and barium are safe contrast agents to use in post-esophagectomy contrast esophagram. Because of the low sensitivity in detecting cervical anastomotic leaks, routine contrast esophagram is not advised. For patients with intrathoracic anastomoses, it is still an effective method for detecting anastomotic leaks.
authors.affiliation: Division of Thoracic Surgery, Huai'an First People's Hospital, Nanjin Medical University, No. 6 West Beijin Road, Huai'an, Jiangsu, China.
authors.forename: Zhongwu
authors.initials: Z
authors.lastname: Hu
authors.affiliation: Division of Thoracic Surgery, Huai'an First People's Hospital, Nanjin Medical University, No. 6 West Beijin Road, Huai'an, Jiangsu, China.
authors.forename: Xiaowe
authors.initials: X
authors.lastname: Wang
authors.affiliation: Division of Thoracic Surgery, Huai'an First People's Hospital, Nanjin Medical University, No. 6 West Beijin Road, Huai'an, Jiangsu, China.
authors.forename: Xush
authors.initials: X
authors.lastname: An
authors.affiliation: Section of General Thoracic Surgery, Department of Diagnostic Radiology, Huai'an First People's Hospital, Nanjin Medical University, No. 6 West Beijin Road, Huai'an, Jiangsu, China.
authors.forename: Wenjin
authors.initials: W
authors.lastname: Li
authors.affiliation: Section of General Thoracic Surgery, Department of Diagnostic Radiology, Huai'an First People's Hospital, Nanjin Medical University, No. 6 West Beijin Road, Huai'an, Jiangsu, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Feng
authors.affiliation: Division of Thoracic Surgery, Huai'an First People's Hospital, Nanjin Medical University, No. 6 West Beijin Road, Huai'an, Jiangsu, China. yhayyxw@163.com.
authors.forename: Zhenbing
authors.initials: Z
authors.lastname: You
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000175:diagnosis*; D003287:Contrast Media; D003974:Diatrizoate Meglumine; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D004947:Esophagus / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D003974:Diatrizoate Meglumine