Gastric interposition following transhiatal esophagectomy: radiographic evaluation

Gastric interposition was achieved in 138 patients following transhiatal esophagectomy without thoracotomy. Among these, 33 had benign and 105 malignant lesions. All patients were evaluated on the 10th postoperative day with a barium swallow examination. However, if an anastomotic leak was suspected clinically before this time, a water-soluble contrast study was initially obtained. Early postoperative complications included anastomotic leaks (15), cricopharyngeal incoordination with aspiration (6), and gastric perforation (2). Late postoperative complications included anastomotic strictures (12), pyloric stenosis (4), recurrence of tumor (3), and transhiatal visceral herniation (2). Our technique of postoperative radiographic evaluation, particularly when a leak is suspected clinically, is discussed.