• 作者：Á ; lvaro Dí ; az de Liañ ; o Argü ; elles^a ; ^{adiazdea@cfnavarra.es} ; Gustavo Sá ; nchez Garcí ; a^b ; Concepció ; n Yá ; rnoz Irazá ; bal^a ; Alicia Artajona Rosino^a
• 关键词：Esofaguectomí ; a ; Anastomosis esó ; fago-gá ; strica intratorá ; cica ; Dehiscencia
• 刊名：Cirug铆a Espa帽ola
• 出版年：2011
• 期刊代码：pca87_0009739X
• 类别：med
• 出版时间：March 2011
• 卷：89
• 期：3
• 页码：175-181
• 文件大小：296 K

Introduction

Oesophagectomy is the principal treatment for cancer of the oesophagus. The oesophagogastric anastomotic leak is a serious complication of the Ivor Lewis operation, and is associated with increased mortality. The objective of this study is to analyse its incidence, its diagnosis and treatment results.

Material and methods

A descriptive analysis of a consecutive series of oesophagectomies, carried out during a 5 year period, using the Ivor Lewis technique. All patients had hand sewn anastomosis. Data were collected on general morbidity, anastomosis leak, hospital mortality, survival, and stenosis of the anastomosis.

Results

A total of 41 intrathoracic anastomoses were performed. Complications, of any type, were observed in 49%of cases, of which 3 (7.3%) were anastomotic leaks, one of them asymptomatic. One patient was urgently reoperated, and two others were treated with drains and conservative treatment. The mortality of the series was 7.3%, none associated with the anastomotic leak. The survival at 5 years was 27%, and 34%of the patients developed stenosis of the anastomosis.

Conclusions

Intrathoracic anastomosis after oesophagectomy, in our experience, can be performed with a low incidence of anastomotic leaks and without mortality due to this cause. Their treatment must be individualised and a considerable proportion do not require surgical intervention.