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. 2023 Feb 1;33(1):31-36.
doi: 10.1097/SLE.0000000000001130.

Suction Drainage for Anastomotic Leakage After Ivor Lewis Esophagectomy

Merel Lubbers  1 , Marc J van Det  1 , David Crull  1 , Andries van der Linden  2 , Anton A Vrij  2 , Ewout A Kouwenhoven  1
Affiliations

Suction Drainage for Anastomotic Leakage After Ivor Lewis Esophagectomy

Merel Lubbers et al. Surg Laparosc Endosc Percutan Tech. .

Abstract

Background: Anastomotic leakage is one of the most life-threatening complications after Ivor Lewis esophagectomy (ILE), with various treatment strategies. Endoscopic techniques are emerging as a less invasive alternative to surgery. Among the current endoscopic techniques, a single placement of an endoluminal nasogastric tube inside the cavity with controlled suction drainage (SD) seems to be an attractive option. The aim of this study was to evaluate the efficacy of SD as treatment for anastomotic leakage after ILE.

Methods: This retrospective analysis was performed among patients who underwent ILE in a high-volume esophageal cancer center in the Netherlands. Patients with an anastomotic leakage that received SD as primary treatment were selected. A nasogastric tube was endoscopically placed into the cavity of the leakage for controlled suction with 15 mm Hg.

Results: A total of 34 patients received SD and was successful in 26 patients (77%). Seven patients (21%) developed empyema despite the SD for which additional video-assisted thoracoscopic surgery was performed. Mortality was 5.9% (2 patients) and median intensive care unit and hospital stay were 3 days (1 to 9) and 25 days (14 to 43), respectively. The median time to closure of the leak was 41 days (23 to 65). A total of 16 patients underwent home treatment for a median of 23 (14 to 42) days.

Conclusions: Controlled SD seems to be an effective treatment for anastomotic leakage after ILE. This therapy can safely and effectively be completed in an ambulant, outpatient setting.

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Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Rutegard M, Lagergren P, Rouvelas I, et al. Intrathoracic anastomotic leakage and mortality after esophageal cancer resection: a population-based study. Ann Surg Oncol. 2012;19:99–103.
    1. Junemann-Ramirez M, Awan MY, Khan ZM, et al. Anastomotic leakage post-esophagogastrectomy for esophageal carcinoma: retrospective analysis of predictive factors, management and influence on longterm survival in a high volume centre. Eur J Cardiothorac Surg. 2005;27:3–7.
    1. Alldinger I, Sisic L, Hochreiter M, et al. Outcome, complications, and mortality of an intrathoracic anastomosis in esophageal cancer in patients without a preoperative selection with a risk score. Langenbecks Arch Surg. 2015;400:9–18.
    1. Hagens ERC, Anderegg MCJ, van Berge Henegouwen MI, et al. International survey on the management of anastomotic leakage after esophageal resection. Ann Thorac Surg. 2018;106:1702–1708.
    1. Schniewind B, Schafmayer C, Voehrs G, et al. Endoscopic endoluminal vacuum therapy is superior to other regimens in managing anastomotic leakage after esophagectomy: a comparative retrospective study. Surg Endosc. 2013;27:3883–3890.

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