Kong Feng-Wei, Wang Wei-Min, Liu Lei, Wu Wen-Bin, Gong Long-Bo, Zhang Miao
Department of General Surgery, Xuzhou Infectious Disease Hospital, Xuzhou.
Department of Gastroenterology of Yichang Central People's Hospital, Institute of Digestive Disease, China Three Gorges University, Yichang.
Medicine (Baltimore). 2020 Oct 2;99(40):e22479. doi: 10.1097/MD.0000000000022479.
Late-onset anastomotic leak (AL) is an uncommon but potentially lethal complication after esophagectomy.
A 74-year-old male patient was readmitted due to chest distress and chills about 3 months after initial esophagectomy for cancer.
The previous endoscopic biopsy revealed primary esophageal squamous cell carcinoma, and sweet esophagectomy with gastric conduit reconstruction was therefore performed. The patient developed AL 3 months after the surgery.
Naso-leakage extraluminal drainage tube was utilized because the symptoms of the patient were aggravated 1 month after the chest tube drainage since his second admission for AL.
Twenty-one days after naso-leakage extraluminal drainage, the computed tomography images showed the healing of the leakage. Then the patient was discharged from the hospital.
Late-onset AL should be kept in mind when the patient complained of chest distress and fever during the follow up after esophagectomy. In addition, naso-leakage extraluminal drainage could be considered for the treatment of AL. Further trials for better evidence are warranted.
迟发性吻合口漏（AL）是食管切除术后一种罕见但可能致命的并发症。
一名74岁男性患者在初次因癌症行食管切除术后约3个月，因胸部不适和寒战再次入院。
先前的内镜活检显示为原发性食管鳞状细胞癌，因此进行了食管切除加胃代食管重建术。患者术后3个月发生了AL。
因患者第二次因AL入院后，胸腔闭式引流1个月后症状加重，故采用鼻漏腔外引流管。
鼻漏腔外引流21天后，计算机断层扫描图像显示漏口愈合。随后患者出院。
食管切除术后随访期间，当患者出现胸部不适和发热时，应考虑迟发性AL。此外，对于AL的治疗可考虑采用鼻漏腔外引流。有必要进行进一步试验以获得更好的证据。
