Feasibility of intraluminal oxygen delivery after minimally invasive esophagus resection

Anastomotic leakage (AL) is a severe complication after esophagectomy. Intraluminal oxygen delivery at the anastomosis site might improve the viability of the tissue and thereby reduce the incidence of AL. We present a feasibility study of intraluminal oxygen delivery after esophagectomy.

Eighteen patients scheduled for robot-assisted minimally invasive esophagectomy with an intrathoracic anastomosis were selected to receive an additional manometry catheter for intraluminal oxygen delivery at the anastomosis site. The primary endpoint was the feasibility of placing the catheter in the correct position and staying in situ for five days postoperatively. Intraluminal pressure was monitored during oxygen delivery at flow rates of 0 (control group), 1, 2, or 4 ml/min. Patients were questioned on the comfort of the catheter.

In two patients, intraoperative placement of the catheter was unsuccessful. Two others replaced these patients according to the study protocol. 16 patients were analyzed. In five patients, the catheter was accidentally removed before the end of the study. The primary endpoint was successful in 11/16 patients (69 %). Intraluminal pressure in the 1 ml/min group did not differ from the control group. Intraluminal pressure in the 2 ml/min group increased substantially compared to the control group. Patients reported comfort rates that decreased over time.

This study shows that it is feasible to administer intraluminal oxygen in the first five days after esophagectomy and that a flow rate of 1 ml/min is not associated with increased intraluminal pressure. Future studies are required to study the effectiveness of intraluminal oxygen delivery in preventing AL.