Nederlof N, de Jonge J, de Vringer T, Tran T C K, Spaander M C W, Tilanus H W, Wijnhoven B P L
Department of Surgery, Erasmus MC University Medical Centre Rotterdam, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
J Gastrointest Surg. 2017 Feb;21(2):251-258. doi: 10.1007/s11605-016-3268-y. Epub 2016 Nov 14.
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.
All 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.
Some 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 %.
In patients without clinical suspicion of leakage, there is no benefit to perform routine examinations.
吻合口漏是食管切除术后的一种严重并发症。目的是探讨常规吞咽造影检查和内镜检查对食管癌切除术后患者吻合口裂开的诊断及预测价值。
从机构数据库中选取2005年1月至2009年12月期间因癌症行食管切除术后7天内接受吞咽造影和/或内镜检查的所有患者。
约173例患者接受了内镜检查，184例患者接受了吞咽造影检查。内镜检查对需要干预的吻合口漏的敏感性为56%，特异性为41%，阳性预测值（PPV）为8%，阴性预测值（NPV）为95%。吞咽造影检查对无漏出迹象患者中检测到需要干预的漏出的敏感性为20%，特异性为20%，PPV为3%，NPV为97%。
在无临床漏出怀疑的患者中，进行常规检查并无益处。
