Huang Yaochen, Fu Xiangning, Fu Shengling
Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Surg. 2023 Feb 22;10:1140839. doi: 10.3389/fsurg.2023.1140839. eCollection 2023.
Anastomotic leakage is a life-threatening complication for esophageal cancer patients who received McKeown esophagectomy. Cervical drainage tube penetrating anastomosis is a rare but noteworthy cause of long-term nonunion of esophagogastric anastomosis. Here we reported two cases of esophageal cancer patients who received McKeown esophagectomy. The first case acquired the anastomotic leakage on postoperative day (POD) 7, and lasted for 56 days. The cervical drainage tube was removed at POD 38, and the leakage healed in 25 days. The second case acquired the anastomotic leakage on POD 8 and lasted for 95 days. The cervical drainage tube was removed at POD 57, and the leakage healed in 46 days. The two cases demonstrated the duration-prolonging effect of drainage tube penetrating anastomosis, which should not be overlooked in clinical practice. We suggested paying attention to the duration of leakage, the drainage fluids amounts and characteristics, and the imaging manifestations to help diagnose. If the cervical drainage tube penetrated the anastomosis, the tube should be eliminated as soon.
吻合口漏是接受McKeown食管癌切除术的患者面临的一种危及生命的并发症。颈部引流管穿透吻合口是食管胃吻合口长期不愈合的一个罕见但值得关注的原因。在此，我们报告了2例接受McKeown食管癌切除术的患者。第一例在术后第7天发生吻合口漏，持续了56天。颈部引流管在术后第38天拔除，漏口在25天内愈合。第二例在术后第8天发生吻合口漏，持续了95天。颈部引流管在术后第57天拔除，漏口在46天内愈合。这两例病例显示了引流管穿透吻合口对愈合时间的延长作用，在临床实践中不应被忽视。我们建议关注漏口持续时间、引流液量及特征以及影像学表现以协助诊断。如果颈部引流管穿透了吻合口，应尽早拔除该引流管。
