Abstract
BackgroundAnastomotic leakage is a severe complication after esophagectomy. The objective was to investigate the diagnostic and predictive value of routine contrast swallow study and endoscopy for the detection of anastomotic dehiscence in patients after esophagectomy. MethodsAll patients who underwent contrast swallow and/or endoscopy within 7 days after oesophagectomy for cancer between January 2005 and December 2009 were selected from an institutional database. ResultsSome 173 patients underwent endoscopy, and 184 patients underwent a contrast swallow study. The sensitivity of endoscopy for anastomotic leakage requiring intervention is 56 %, specificity 41 %, positive predictive value (PPV) 8 %, and negative predictive value (NPV) 95 %. The sensitivity of contrast swallow study for detecting leakage requiring intervention in patients without signs of leakage was 20 %, specificity 20 %, PPV 3 %, and NPV 97 %. ConclusionsIn patients without clinical suspicion of leakage, there is no benefit to perform routine examinations.
Highlights
Leakage of the cervical esophagogastrostomy after esophagectomy with gastric tube reconstruction occurs in 5–25 % of patients, and is associated with significant morbidity, and accounts for 25–50 % of postoperative deaths.[1,2,3] Signs and symptoms of anastomotic leakage are fever, tachycardia, and manifestations at the surgical site including redness, swelling, and drainage of saliva and pus
Summary for Table of Contents This study investigates the diagnostic and predictive value of routine contrast swallow study and endoscopy in postoperative management of patients after esophagectomy
In order to detect anastomotic leakage before clinical signs develop and the patients deteriorate, contrast swallow and/or endoscopy are often performed within the first week after surgery
Summary
Leakage of the cervical esophagogastrostomy after esophagectomy with gastric tube reconstruction occurs in 5–25 % of patients, and is associated with significant morbidity, and accounts for 25–50 % of postoperative deaths.[1,2,3] Signs and symptoms of anastomotic leakage are fever, tachycardia, and manifestations at the surgical site including redness, swelling, and drainage of saliva and pus. In order to detect anastomotic leakage before clinical signs develop and the patients deteriorate, contrast swallow and/or endoscopy are often performed within the first week after surgery. Anastomotic leakage is a severe complication after esophagectomy. The objective was to investigate the diagnostic and predictive value of routine contrast swallow study and endoscopy for the detection of anastomotic dehiscence in patients after esophagectomy
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
