Original Article Treatment of postoperative intrathoracic reconstruction after digestive tract fistula in esophageal and cardiac carcinoma

Su Chen, Naixiang Huang
2017 Int J Clin Exp Med   unpublished
Objective: Anastomotic leakage and thoracic-gastric leakage, collectively known as leakage of the tho-racic esophageal anastomosis, remains one of the most severe postoperative complications of esophagoctomy and esophagogastrostomy. We proposed and tested a treatment strategy consisting of staging and fistulation. Methods: The clinical records of 23 patients with intrathoracic reconstruction fistula after esophagectomy or esophagogas-trostomy from 1998 to 2014 were analyzed retrospectively. We
more » ... lassified the patients into 1 of 2 groups: Group A consisted of 12 patients treated immediately with the traditional "3-tubes therapy": a closed thoracic drainage tube, a Miller-Abbott tube, and an enteral nutrition tube after diagnosis. Group B consisted of 11 patients treated with our staging and fistulation therapy, which consists of classification, treatment, cultivation, and narrowing and closing the fistula. The treatment duration and mortality rate were observed. SPSS 20.0 was used in analyzing the data. P<0.05 was considered statistically significant. Results: Twenty patients recovered, and 3 patients died. The average treatment duration of group B (27±5.81) was shorter than that of group A (41.3±14.3). Therapeutic efficacy was also more obvious in group B (P<0.05). The mortality rate was not statistically different between the groups (P>0.05). Conclusions: Treatment of postoperative intrathoracic esophageal anastomotic leaks should be individualized. Evaluation, staged treatment, cultivation, and narrowing and closing of the fistula are essential to staging and fistulation therapy.