Cafarotti Stefano, Cesario Alfredo, Porziella Venanzio, Leuzzi Giovanni, Vita Maria Letizia, Meacci Elisa, Congedo Maria Teresa, Granone Pierluigi
Ann Ital Chir. 2013 Mar-Apr;84(2):137-41.
Esophageal anastomotic leaks are associated with significant morbidity and mortality. The purpose of this study was to retrospectively assess the role of the anastomotic positioning (thoracic or cervical) on the incindence of the anastomotic leak and its severity.
In the period 2002-07, we have performed extended esophagectomy with a curative-intent in 63 patients with esophageal cancer. The clinical outcome of the 46 patients where a cervical anastomosis was performed (Group A) has been compared with that of the 17 with thoracic anastomosis (Group B), in terms of leak incidence, pattern of healing, morbidity, and mortality.
Leaks occurred in 11% patients of the in group A and in 8% of the group B. When the dehiscence has occurred in the cervical region 1/4th of patients died before the 30th post-operative day compared to the 3/5th of those where the leak occurred at the level of the thorax.
On the basis of our findings we suggest the adopt the cervical anastomosis due to lower mortality rate related when leaks occur.
食管吻合口漏与显著的发病率和死亡率相关。本研究的目的是回顾性评估吻合口位置（胸段或颈段）对吻合口漏发生率及其严重程度的作用。
在2002年至2007年期间，我们对63例食管癌患者进行了根治性扩大食管切除术。将行颈段吻合术的46例患者（A组）与行胸段吻合术的17例患者（B组）在漏发生率、愈合方式、发病率和死亡率方面的临床结果进行了比较。
A组11%的患者发生了吻合口漏，B组为8%。当吻合口漏发生在颈部区域时，1/4的患者在术后30天内死亡，而漏发生在胸段水平的患者中这一比例为3/5。
根据我们的研究结果，我们建议采用颈段吻合术，因为漏发生时其相关死亡率较低。
