Management of esophageal dehiscences by an intraluminal bypass tube. An experimental study

The high incidence of leaks from esophageal anastomoses and the significant morbidity resulting from spontaneous or iatrogenic perforations have prompted an experimental study involving the protection of esophageal anastomoses, dehiscences, and perforation by use of an intraluminal bypass graft. To accomplish this, a specially prepared soft tube is inserted that conducts the salivary and esophageal secretions and ingested food to the stomach, thus preventing any contact with the anastomotic site. Even in the face of surgically created gross esophageal anastomotic dehiscences and perforations, there has been a complete absence of leakage as evidenced by barium studies and by gross and microscopic examination of anastomoses and dehiscences. The technique of inserting the intraluminal bypass graft and its efficacy in protecting the esophageal anastomoses with gross dehiscences has been presented.