Association of Women SurgeonsOptimal approach to the management of intrathoracic esophageal leak following esophagectomy: a systematic review
Section snippets
Data Sources
Eligible studies for inclusion were identified using a systematic search strategy (Table 1). Titles and abstracts of 465 articles were reviewed and all English language studies examining intrathoracic esophageal anastomotic leak after esophagectomy were identified for inclusion. Articles were excluded if they were published in abstract only, reported leaks predominately for operations other than esophagectomy and esophagogastric anastomosis, were case reports with less than 3 patients, or did
Conclusions
Early recognition and appropriate management of intrathoracic anastomotic leaks have decreased leak-associated mortality, yet morbidity associated with the complication remains significant. Over the past several decades, there has been a shift in management of anastomotic leaks from aggressive surgical intervention to conservative management, and more recently to increasing utilization of endoscopic interventions. The basic principles of these management strategies remain the same, including
References (47)
- et al.
Endoscopic management of anastomotic esophageal leaks
Tech Gastrointest Endosc
(2006) - et al.
Endoscopic treatment of clinically symptomatic leaks of thoracic esophageal anastomoses
Gastrointest Endosc
(2000) Leaks, strictures, and necrosis: a review of anastomotic complications following esophagectomy
Semin Thorac Cardiovasc Surg
(2004)- et al.
A method for early diagnosis and treatment of intrathoracic esophageal anastomotic leakage: prophylactic placement of a drainage tube adjacent to the anastomosis
J Gastrointest Surg
(2012) - et al.
Use of pedicled omentum in esophagogastric anastomosis for prevention of anastomotic leak
Ann Thorac Surg
(2006) - et al.
Wrapping of the omental pedicle flap around esophagogastric anastomosis after esophagectomy for esophageal cancer
Surgery
(2011) - et al.
Utility of silicone esophageal bypass stents in the management of delayed complex esophageal disruptions
Ann Thorac Surg
(2008) - et al.
New covered mushroom-shaped metallic stent for managing anastomotic leak after esophagogastrostomy with a wide gastric tube
Ann Thorac Surg
(2006) - et al.
Esophageal stents for anastomotic leaks and perforations
J Thorac Cardiovasc Surg
(2011) - et al.
Esophageal leaks repaired by a muscle onlay approach in the presence of mediastinal sepsis
Ann Thorac Surg
(2009)
Management of postoperative esophageal leaks with the polyflex self-expanding covered plastic stent
Ann Thorac Surg
Healing occurs in most patients that receive endoscopic stents for anastomotic leakage; dislocation remains a problem
Clin Gastroenterol Hepatol
Esophageal salvage with removable covered self-expanding metal stents in the setting of intrathoracic esophageal leakage
Am J Surg
Management of esophageal anastomotic leaks, perforations, and fistulae with self-expanding plastic stents
J Thorac Cardiovasc Surg
Esophageal stent placement for the treatment of acute intrathoracic anastomotic leak after esophagectomy
Ann Thorac Surg
Management of intrathoracic leaks following esophagectomy
Adv Surg
Self-expanding plastic stents for benign esophageal lesions
Gastrointest Endosc
Endoscopic treatment of thoracic esophageal anastomotic leaks by using silicone-covered, self-expanding polyester stents
Gastrointest Endosc
Treatment of thoracic esophageal anastomotic leaks and esophageal perforations with endoluminal stents: efficacy and current limitations
J Gastrointest Surg
Management of gastrointestinal leaks after minimally invasive esophagectomy: conventional treatments vs. endoscopic stenting
J Gastrointest Surg
Anastomotic leakage after esophageal resection: new treatment options by endoluminal vacuum therapy
Ann Thorac Surg
Anastomotic complications after esophagectomy
Dig Surg
Anastomotic leakage post-esophagogastrectomy for esophageal carcinoma: retrospective analysis of predictive factors, management and influence on longterm survival in a high volume centre
Eur J Cardiothorac Surg
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Supported by the National Cancer Institute of the National Institutes of Health under award numbers 5K07CA151613 (K.S.N.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.