The effect of a novel slow-flow irrigation drainage tube on anastomotic leakage and empyema after the resection of esophageal or gastroesophageal junction cancer.

Abstract

Anastomotic leakage with empyema is one of the most severe complications of esophagectomy. We invented a new type of slow-flow irrigation drainage tube to improve the smooth pleural drainage, which contributed to the recovery of anastomotic leakage. In this study, 42 patients, from 2012 to 2019, who underwent esophagectomy and postoperative anastomotic leakage with persistent empyema, were enrolled and distributed into irrigation drainage tube group (I+) or non-irrigation drainage tube group (I-). In (I+) group, the slow-flow irrigation drainage tube was placed along the primary pleural drainage tube into the empyema cavity, irrigated with normal saline. Clinicopathological features and perioperative complications of all patients were collected and compared to determine the differences between the two groups with statistical analysis. All 20 patients were distributed into (I+) group and 22 into (I-) group. The two groups were comparable in clinicopathological features. When compared with (I-) group, patients in (I+) group achieved significantly shorter healing duration and postoperative hospital stay. The complications resulting from anastomotic leakage in (I+) group were relatively fewer than those in (I-) group, including postoperative bleeding (0 vs. 1) and pulmonary complications (7 vs. 13). Moreover, 5 reoperations for rescuing bleeding or severe thoracic infection were performed in (I-) group, while none in (I+) group. The slow-flow irrigation drainage tube is a safe and effective treatment of anastomotic leakage and empyema. Additional prospective study is required to furtherly determine the improvement of drainage and extended application in deep infections located in thorax.