Abstract
Objective: This observational study was done to know the factors responsible and management of suction pneumothorax after trans-hiatal esophagogastrectomy. Materials and Methods: Progressive observational study of 415 patients who underwent trans-hiatal esophagogastrectomy and 35 patients who underwent trans-abdominal esophago-gastrectomy in last five years, for carcinoma esophagus and followed in immediate post-operative period for suction pneumothorax. Results: Ten patients from trans-hiatal group and two patients from trans-abdominal group complicated with suction pneumothorax in immediate post-operative period. It is the corrugated rubber drain site behind the neck incision close to esophago-gastric anastomosis which is responsible for maximum number of cases of suction pneumothorax. Withdrawal of corrugated rubber drain is the first and effective treatment, if diagnosis is made at an earliest point of occurrence of suction pneumothorax. If pneumothorax and air leak is not diagnosed and treated, then other fatal pulmonary complications can occur. Conclusion: Trans-hiatal esophageal dissection is usually associated with mediastinal pleural breach, so bilateral intercostal tube thoracostomy is a rational part of this surgery. Also close observation in immediate post-operative period is necessary to pick-up suction pneumothorax at an earliest point of suspicion. Keywords: Trans- hiatal suction pneumothorax, Esophagogastrectomy suction pneumothorax.
Highlights
Transhiatal esophago-gastrectomy has become the standard of thecare for esophageal carcinoma
Two patients diagnosed on second post-operative day with suction pneumothorax had undergone trans-abdominal esophagogastrectomy having one abdominal corrugated rubber drain (CRD), but no intercostal thoracostomy tube drain
It should be noted that transhiatal esophagogastrectomy represents the best surgical option for patients with esophageal carcinoma and high anesthetic risk because it is associated with reduced surgical trauma, decreased incidence of respiratory distress, and length of postoperative stay in hospital. 1All patients of transhiatal esophagogastrectomy need judicious and close postoperative observation to prevent these complications and subsequently morbidity and mortality
Summary
Transhiatal esophago-gastrectomy has become the standard of thecare for esophageal carcinoma. All those patients who undergotrans-hiatal esophago-gastrectomy, predominantly for malignant lesion of the esophagus, corrugated rubber drain CRD is usually put behind the cervical incision at the esophago-gastric anastomotic site in the neck and in the abdomen close to diaphragmatic hiatus, in addition to bilateral intercostal thoracostomy tubes to drain the dissection area and anastomotic site in case of leaks. In patients who undergo transabdominal esophagogastrectomy, single corrugated rubber drain or tube drain is put in the abdomen close to the esophago-gastric anastomotic site at the diaphragmatic hiatus
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 call
