Abstract：
This state-of-the-art review explores the intricacies of anastomotic leaks following oesophagectomy and gastrectomy, crucial surgeries for globally increasing esophageal and gastric cancers. Despite advancements, anastomotic leaks occur in up to 30 % and 10 % of oesophagectomy and gastrectomy cases, respectively, leading to prolonged hospital stays, substantial impact upon short- and long-term health-related quality of life and greater mortality. Recognising factors contributing to leaks, including patient characteristics and surgical techniques, are vital for preoperative risk stratification. Diagnosis is challenging, involving clinical signs, biochemical markers, and various imaging modalities. Management strategies range from non-invasive approaches, including antibiotic therapy and nutritional support, to endoscopic interventions such as stent placement and emerging vacuum-assisted closure devices, and surgical interventions, necessitating timely recognition and tailored interventions. A step-up approach, beginning non-invasively and progressing based on treatment success, is more commonly advocated. This comprehensive review highlights the absence of standardised treatment algorithms, emphasizing the importance of individualised patient-specific management.
摘要：
这篇最新的综述探讨了食管切除术和胃切除术后吻合口漏的复杂性，全球食管癌和胃癌的关键手术。尽管取得了进步，吻合口漏发生在高达30%和10%的食管切除术和胃切除术病例中，分别,导致住院时间延长,对短期和长期健康相关生活质量和更高死亡率的重大影响。认识到导致泄漏的因素，包括患者特征和手术技巧，对术前风险分层至关重要。诊断具有挑战性,涉及临床症状，生化标志物,和各种成像方式。管理策略包括非侵入性方法，包括抗生素治疗和营养支持，内窥镜干预措施，如支架放置和新兴的真空辅助闭合装置，和手术干预，需要及时承认和量身定制的干预措施。一种逐步升级的方法，非侵入性地开始，并在治疗成功的基础上进步，更普遍地提倡。这篇全面的综述强调了缺乏标准化的治疗算法，强调个性化患者特定管理的重要性。
