Antireflux Resection of Mucous Membrane of Esophagogastric Anastomosis in Treatment of Barrett’s Esophagus: Initial Experience

Смирнов, А. А.; Vasilevskiy, D. I.; Lapshin, A S; Dvoretskiy, S. Yu.; Filippov, Denis; Цицкарава, А. З.; Bagnenko, S. F.

doi:10.24884/0042-4625-2016-175-4-59-61

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“…Postoperative anastomotic leakage has been one of the main causes of poor prognosis in patients, which plagues thoracic surgeons [3,4]. With the continuous improvement of surgical techniques and anastomosis methods, the incidence of anastomotic leakage after esophageal cancer surgery is generally 1.0-5.5% as reported in recent years in China [5]. If not treated effectively in time, the condition may further develop and worsen, inducing induced MODS, especially intrathoracic anastomotic leakage, with a higher mortality than other gastrointestinal anastomotic leaks, which is the main cause of perioperative mortality in esophageal cancer and the characteristics included that The time of anastomotic leakage such as early leakage, mid-term leakage and late leakage found was 4 to 45 days, with a median time of 10 days.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic injection of human fibrin sealant in treatment of intrathoracic anastomotic leakage after esophageal cancer surgery

Chen

Yuan

Chen

et al. 2020

J Cardiothorac Surg

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Objective To investigate the application of endoscopic injection of human fibrin sealant in treatment of patients with intrathoracic anastomotic leakage after esophagectomy. Methods A total of 179 patients who underwent intrathoracic anastomosis after esophageal cancer surgery in our department From December 2012 to May 2015 were retrospectively analyzed. The clinical data and treatment of 7 patients with postoperative intrathoracic anastomotic leakage were analyzed and discussed. On Day 28 after operation, the 7 patients were given endoscopic injection of human fibrin sealant to seal the anastomotic leakage, and the changes in drainage volume, body temperature, CRP, white blood cell count and other indicators were compared before and after endoscopic intervention. Results After endoscopic injection of human fibrin sealant in all 7 patients with intrathoracic anastomotic leakage, the volume of para-anastomotic drainage, CRP, and WBC count were improved compared with those before treatment. Relevant data were analyzed, and the differences were statistically significant (P = 0.019, P = 0.001, P = 0.014, respectively). No statistically significant difference was observed in the body temperature before and after treatment (P = 0.217). Conclusion For patients with intrathoracic anastomotic leakage after esophageal cancer surgery, endoscopic injection of human fibrin sealant to seal the anastomotic leakage has positive therapeutic effects of reducing exudation around the anastomotic leakage, reducing systemic inflammatory response, and improving clinical symptoms including dysphagia, weight loss without trying, chest pain, pressure or burning, worsening indigestion or heartburn and coughing or hoarseness.

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Section: Introductionmentioning

confidence: 99%