Intrathoracic anastomotic leaks after esogastrectomy and esogastric anastomosis by double abdominal and thoracic incision for esophageal cancer

The aim of this study was to evaluate the methods o f diagnosis and the results of the treatment of anastomotic leaks after esogastrestomy for carcinom a. A retrospective study was done from January 1 st , 1996 through December 31, 2008. The circumstances of diagnosis and the results of the treatment of postoperative intra thoracic anastomotic leaks were analyzed. It concerned 13 patients out of 71 consecutive patients treated by esogastrectomy with immediate esogastric anastomosis by double abdominal and right thoracic ways for esophageal ca rcinoma. The rate of anastomotic leaks was 18.3%. The leaks had occurred mainly during the first 13 p ostoperative days. The warning signs of anastomotic leaks were a discharge of pus or bile in the pleura l drain in 46.1% of cases, and pulmonary symptoms i n 30.8% of cases. The patients had a medical treatmen t (11 cases; 76.9%). Esophageal stent was introduced by endoscopic way in 2 cases (15.4%). In one case (7.7%), another thoracotomy was performed in emergency to repair the esogastric ana stomosis. The chemical glues were not used. There was no statistically significant difference (p=0.77 2) between the mortality of the patients who had a post-operative leak (7.7%) and the mortality withou t any leak (10.3%).