Reexploration for complications after esophagectomy for cancer

Among 316 patients who underwent resection for esophageal cancer, 23 required reexploration for complications and 10 died. The commonest reason for reexploration was leakage (eight patients). Development of leakage necessitating reexploration was associated with a hospital mortality rate of 75%. Other reasons for reexploration were postoperative bleeding (n = 7), chylothorax (n = 2), burst abdomen (n = 2), diaphragmatic herniation (n = 1), bile peritonitis (n = 1), bowel gangrene (n = 1), and tracheal perforation (n = 1). Definite or presumed technical error could be identified in 18 of the 23 patients requiring reexploration and indicated that the majority of reexplorations were for complications that appeared to be potentially avoidable. When reexploration became necessary, early intervention offered the best chance of survival.