Department of Surgery, Klinikum rechts der Isar, Technische Universität München, 81675, Munich, Germany.
Department of Internal Medicine, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr, 22, 81675, Munich, Germany.
World J Surg Oncol. 2022 Mar 31;20(1):104. doi: 10.1186/s12957-022-02551-z.
Malignant tumors of the esophagus are the sixth leading cause of cancer-related deaths worldwide. Postoperative leakage of the esophago-gastrostomy leads to mediastinal sepsis, which is still associated with a high morbidity and mortality rate. The aim of this study was to describe the endoscopic view of the different severity grades of an anastomotic leakage.
Patients Between June 2016 and September 2018, 144 patients were operated upon in the Department of Surgery, University of Munich, Germany. Among these patients, 34 (23.6%) presented with a leakage of the anastomosis. Endoscopy In this retrospective analysis, the focus is to describe different patterns of leakage of the anastomosis.
We studied 34 patients in whom post-esophagectomy leakage of the anastomosis was detected and treated with an endoluminal vacuum sponge system. The leakage healed in 26 of 29 patients (success rate 89.7%). With the increasing severity of leakage, the treatment time and the in-hospital mortality correspondingly increased. Furthermore, the incidence of the development of a fistula to the tracheobronchial system increased with higher grades of leakage.
Exact descriptions of leakage are necessary to compare the cases and to prove post-treatment improvement. This is, to our knowledge, the first publication to present a leakage grading score in patients after esophagectomy including reconstruction with a gastric tube. This new grading system needs to be tested in further analyses, with a special focus on prospective analysis.
食管癌是全球第六大致癌相关死亡原因。食管胃吻合口术后漏会导致纵隔感染，这仍然与高发病率和死亡率相关。本研究的目的是描述吻合口不同严重程度的内镜下表现。
2016 年 6 月至 2018 年 9 月，德国慕尼黑大学外科系对 144 例患者进行了手术。其中 34 例（23.6%）出现吻合口漏。在这项回顾性分析中，内镜检查的重点是描述不同类型的吻合口漏。
我们研究了 34 例接受内镜下真空海绵系统治疗的食管切除术后吻合口漏患者。29 例患者中有 26 例（成功率 89.7%）愈合。随着漏的严重程度增加，治疗时间和住院死亡率相应增加。此外，随着漏的严重程度增加，瘘管向气管支气管系统发展的发生率也增加。
准确描述漏是必要的，以便对病例进行比较并证明治疗后的改善。据我们所知，这是第一篇在食管切除术后患者中（包括胃管重建）提出漏分级评分的出版物。这一新的分级系统需要在进一步的分析中进行测试，特别要关注前瞻性分析。
