Clinical application of gastrointestinal decompression in anastomotic fistula after McKeown esophagectomy for esophageal cancer.

Abstract

Cervical anastomotic fistula is one of the most common complications after McKeown esophagectomy for esophageal cancer, leading to septic shock and even death. It is therefore very important to provide effective symptom management after diagnosis of anastomotic fistula. Placing the gastrointestinal decompression tube beside the anastomotic site and connecting the tube to a gastrointestinal decompression disk could support the prevention and treatment of anastomotic fistula after surgical treatment of esophageal cancer.Thirty-eight patients with anastomotic fistula after undergoing McKeown esophagectomy for esophageal cancer in our hospital from April 2017 to January 2021 were divided equally into control and observation groups according to the gastrointestinal decompression method used. Gastrointestinal decompression tubes were placed 45 to 50 cm from the incisors in the control group or 25 to 30 cm from the incisors in the observation group. The treatment efficacy was compared between the 2 groups.The drainage time, length of hospital stay after anastomotic fistula detection, and fistula healing time in the observation group were significantly shorter than those in the control group (P < .05 for all).Placing the gastrointestinal decompression tube connected to a gastrointestinal decompression disk next to the anastomotic site is a simple procedure and may significantly improve the drainage time, length of hospital stay, and fistula healing time of patients who develop anastomotic fistula resulting from McKeown esophagectomy for esophageal cancer.