Management of esophageal perforation and anastomotic leak by transluminal drainage

J Gastrointest Surg. 2011 May;15(5):777-81. doi: 10.1007/s11605-011-1472-3. Epub 2011 Mar 1.

Abstract

Introduction: The management of esophageal perforations and leaks remains a challenge. Although there are broad management principles, each situation may require a different surgical approach. The aim of this report was to describe the management of these esophageal crises by transluminal drainage via a transabdominal approach.

Methods: Between 2005 and 2009, patients with anastomotic or gastric staple line leak (n = 4) or esophageal perforation (n = 2) underwent transabdominal surgery and transluminal drainage. This simple technique has, to the best of our knowledge, not been previously reported.

Results: All six patients survived. The median intensive care unit and hospital stays were 12 days (range 0-32) and 63 days (range 32-99), respectively. At a median follow-up time of 25 months (range 15-60), five of the six patients remain alive and well. One patient with node positive esophageal carcinoma has died from relapsed disease.

Conclusions: Transabdominal transluminal drainage should be added to the list of potential techniques that can be employed in management of esophageal leaks and perforations. It is a valuable adjunct to the armamentarium of the esophageal surgeon for dealing with these challenging situations.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Anastomotic Leak / etiology
  • Anastomotic Leak / therapy*
  • Drainage / methods*
  • Esophageal Perforation / etiology
  • Esophageal Perforation / therapy*
  • Esophagectomy / adverse effects*
  • Female
  • Follow-Up Studies
  • Gastrectomy / adverse effects*
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome