Abstract
ObjectiveTo investigate the application of endoscopic injection of human fibrin sealant in treatment of patients with intrathoracic anastomotic leakage after esophagectomy.MethodsA 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.ResultsAfter 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).ConclusionFor 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.
Highlights
At present, the incidence rate of esophageal malignant tumor is about 13/100,000 in China, ranking first in the world [1, 2]
Chen et al Journal of Cardiothoracic Surgery (2020) 15:96 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
Anti-inflammatory treatment, and nutritional support treatment for these 7 patients, the anastomotic leakage was closed by endoscopic injection of fibrin sealant
Summary
The incidence rate of esophageal malignant tumor is about 13/100,000 in China, ranking first in the world [1, 2]. Surgical resection of the lesion along with reconstruction of the digestive tract is the main treatment to prolong the survival time of patients and. Chen et al Journal of Cardiothoracic Surgery (2020) 15:96 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. A total of 179 patients underwent radical resection of intrathoracic anastomotic esophageal cancer in our department from December 2012 to May 2015, and 7 of them had postoperative intrathoracic anastomotic leakage. Anti-inflammatory treatment, and nutritional support treatment for these 7 patients, the anastomotic leakage was closed by endoscopic injection of fibrin sealant. The clinical data were retrospectively analyzed, and the results are reported as follows for the reference of clinical peers
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