PDF(Pubmed)
Abstract：
UNASSIGNED: Anastomotic leakage (AL) following esophagectomy represents a serious complication that often results in prolonged hospitalization and necessitates repeated interventions, including nothing-by-mouth (NPO) restriction, endoscopic vacuum therapy (EVT), or surgical repair. In this study, we evaluated the patterns and outcomes of AL treatment.
UNASSIGNED: We retrospectively reviewed the medical records of patients who underwent esophagectomy for esophageal cancer at a single center between 2003 and 2020. Of 3,096 examined cases, 181 patients (5.8%) with AL were included in the study: 114 patients (63%) with cervical anastomosis (CA) and 67 (37%) with intrathoracic anastomosis (TA).
UNASSIGNED: The incidence of AL was 11.9% in the CA and 3.2% in the TA group (p<0.001). Among patients with CA who developed AL, 87 (76.3%) were managed with NPO, 15 (13.2%) with EVT, and 12 (10.5%) with surgical repair. Over 90% of patients with cervical AL resumed an oral diet by the time of discharge, regardless of treatment method. Among patients with TA and AL, 36 (53.7%) received NPO, 25 (37.7%) underwent EVT, and 6 (9%) required surgery. Of these, 34 patients who were managed with NPO and 19 with EVT could resume an oral diet. However, only 2 patients who underwent surgery resumed an oral diet, and 2 patients required additional EVT.
UNASSIGNED: Although patients with CA displayed a higher incidence of AL, their rate of successful oral intake exceeded that of those with TA, regardless of treatment method. Among patients exhibiting AL with TA, EVT was more commonly employed than in CA cases, and it appears effective.
UNASSIGNED: We retrospectively reviewed the medical records of patients who underwent esophagectomy for esophageal cancer at a single center between 2003 and 2020. Of 3,096 examined cases, 181 patients (5.8%) with AL were included in the study: 114 patients (63%) with cervical anastomosis (CA) and 67 (37%) with intrathoracic anastomosis (TA).
UNASSIGNED: The incidence of AL was 11.9% in the CA and 3.2% in the TA group (p<0.001). Among patients with CA who developed AL, 87 (76.3%) were managed with NPO, 15 (13.2%) with EVT, and 12 (10.5%) with surgical repair. Over 90% of patients with cervical AL resumed an oral diet by the time of discharge, regardless of treatment method. Among patients with TA and AL, 36 (53.7%) received NPO, 25 (37.7%) underwent EVT, and 6 (9%) required surgery. Of these, 34 patients who were managed with NPO and 19 with EVT could resume an oral diet. However, only 2 patients who underwent surgery resumed an oral diet, and 2 patients required additional EVT.
UNASSIGNED: Although patients with CA displayed a higher incidence of AL, their rate of successful oral intake exceeded that of those with TA, regardless of treatment method. Among patients exhibiting AL with TA, EVT was more commonly employed than in CA cases, and it appears effective.
摘要：
■食管切除术后吻合口漏（AL）是一种严重的并发症，通常会导致住院时间延长，需要反复进行干预。包括无口交(NPO)限制，内窥镜真空疗法（EVT），或手术修复。在这项研究中,我们评估了AL治疗的模式和结局.
■我们回顾性回顾了2003年至2020年期间在单个中心接受食管癌切除术的患者的医疗记录。在3096例检查的病例中，研究包括181例AL患者（5.8％）：114例（63％）宫颈吻合（CA）和67例（37％）胸内吻合（TA）。
■CA组AL发生率为11.9%，TA组为3.2%（p<0.001）。在发展为AL的CA患者中，87（76.3%）由非营利组织管理，15（13.2%）与EVT，和12（10.5％）进行手术修复。超过90％的宫颈AL患者在出院时恢复口服饮食，不管治疗方法如何。在TA和AL患者中，36（53.7%）收到NPO，25例（37.7%）接受EVT，和6（9％）需要手术。其中,34例接受NPO治疗的患者和19例接受EVT治疗的患者可以恢复口服饮食。然而,只有两名接受手术的患者恢复了口服饮食，2例患者需要额外的EVT。
■尽管CA患者表现出更高的AL发病率，他们的口服成功率超过了TA患者，不管治疗方法如何。在显示有TA的AL的患者中，EVT比CA更常用，而且看起来很有效.
■我们回顾性回顾了2003年至2020年期间在单个中心接受食管癌切除术的患者的医疗记录。在3096例检查的病例中，研究包括181例AL患者（5.8％）：114例（63％）宫颈吻合（CA）和67例（37％）胸内吻合（TA）。
■CA组AL发生率为11.9%，TA组为3.2%（p<0.001）。在发展为AL的CA患者中，87（76.3%）由非营利组织管理，15（13.2%）与EVT，和12（10.5％）进行手术修复。超过90％的宫颈AL患者在出院时恢复口服饮食，不管治疗方法如何。在TA和AL患者中，36（53.7%）收到NPO，25例（37.7%）接受EVT，和6（9％）需要手术。其中,34例接受NPO治疗的患者和19例接受EVT治疗的患者可以恢复口服饮食。然而,只有两名接受手术的患者恢复了口服饮食，2例患者需要额外的EVT。
■尽管CA患者表现出更高的AL发病率，他们的口服成功率超过了TA患者，不管治疗方法如何。在显示有TA的AL的患者中，EVT比CA更常用，而且看起来很有效.
