Division Head Upper Gastrointestinal Surgery, Department of Visceral and Transplant Surgery, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
Langenbecks Arch Surg. 2020 Dec;405(8):1069-1077. doi: 10.1007/s00423-020-01926-8. Epub 2020 Jul 10.
Surgery remains the cornerstone of esophageal cancer treatment but is burdened with high procedure-related morbidity. Anastomotic leakage as the most important surgical complication after esophagectomy is a key indicator for quality in surgical outcome research.
The aim of this narrative review is to assess and summarize the current knowledge on prevention of anastomotic leakage after esophagectomy and to provide orientation for the reader in this challenging field of surgery.
There are various strategies to reduce postoperative morbidity and to prevent anastomotic leakage after esophagectomy, including adequate patient selection and preparation, and many technical-surgical and anesthesiological details. The scientific evidence regarding those strategies is highly heterogeneous, ranging from expert's recommendations to randomized controlled trials. This review is intended to serve as an empirical guideline to improve the clinical management of patients undergoing esophagectomy with a special focus on anastomotic leakage prevention.
手术仍然是食管癌治疗的基石，但它伴随着高的与手术相关的发病率。吻合口漏是食管癌手术后最重要的手术并发症，也是手术结果研究中质量的关键指标。
本综述的目的是评估和总结目前关于预防食管癌手术后吻合口漏的知识，并为读者提供在这一具有挑战性的手术领域的方向。
有多种策略可以降低术后发病率，预防食管癌手术后吻合口漏，包括充分的患者选择和准备，以及许多技术-外科和麻醉学细节。关于这些策略的科学证据高度异质，从专家建议到随机对照试验都有。本综述旨在作为改善接受食管癌手术患者的临床管理的经验性指南，特别关注吻合口漏的预防。
