243. INTRALUMINAL OXYGEN DELIVERY AT THE SITE OF THE ANASTOMOSIS AFTER A ROBOT ASSISTED MINIMAL INVASIVE ESOPHAGUS RESECTION; A FEASIBILITY STUDY

Abstract

Abstract Anastomotic leakage (AL) is a severe complication after esophagus resection surgery. It is thought that local ischemia of the gastric conduit is one of the main reasons for the relative high incidence of AL (10–20%). Intraluminal oxygen delivery at the site of the anastomosis might improve the viability of the tissue and therefore reduce the incidence of AL. We present a feasibility study to the intraluminal oxygen delivery after an esophagus resection. Patients undergoing a robot assisted minimal invasive esophagus resection with an intrathoracic anastomosis were included in the study. Intraluminal oxygen was administered via an esophagus manometry catheter. In the control group, consisting of 3 patients without oxygen delivery, only intraluminal pressure measurements were conducted. In the next 10 patients, 1 mL/minute of oxygen was given in the first 5 days after surgery. Primary endpoint was the feasibility of successful placement of the catheter at the right position. In addition, patients were asked to evaluate the comfort of the setup with the use of a daily visual analogue scale. In 2 patients, intraoperative placement of the catheter did not succeed. These patients were replaced by 2 others according to the study protocol. Therefore, in total 15 patients were analyzed. In 4 patients, the catheter was accidently luxated or removed before the end of the study. No catheter related complications were observed. The measured intraluminal pressure stabilized on an average value of 7.6 mm Hg (± 2.1). As expected, the experiences comfort was decreasing over time. See the table 1 below for details on comfort evaluation of the catheter setup. This study shows that it is feasible to administer intraluminal oxygen in the first 5 days after a robot assisted minimal invasive esophagus resection. Future studies are required to prove the effectiveness of intraluminal oxygen delivery and its effect on AL. When the effectiveness study shows promising results, the optimal dosage and period of oxygen delivery will have to be determined.