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Diagnosis and treatment of complications after oesophagoplasty
1First Department of Surgery, School of Medicine, Tokyo Medical and Dental University, Japan.
Objective:
To find out the optimal method for diagnosing and treating anastomotic leaks and necrosis of the organs used for reconstruction after resection of oesophageal cancer and oesophagoplasty.
Design:
Retrospective study.
Setting:
University department, Japan.
Subjects:
481 patients who underwent resection of oesophageal cancer and subsequent oesophagoplasty (including 47 postoperative anastomotic leaks and 10 cases of necrosis of the organs used for reconstruction).
Main Outcome Measures:
Morbidity and mortality.
Results:
Of 47 patients with anastomotic leaks 2 died during their hospital stay as did 3 (30%) of 10 patients with necrosis. Necrosis was most common in cases in which the colon had been harvested by the presternal route (4/13, 31%). Secondary reconstruction with a free jejunal graft was successful in 3/4 cases.
Conclusion:
Most anastomotic leaks were cured by conservative treatment. In cases of necrosis of the organs used for reconstruction, early drainage and secondary reconstruction with free jejunal grafts yielded the best results.