Abstract
Background: Intrathoracic esophageal anastomotic leakage (AL) is one of the most fatal complications after esophagectomy. In this study, we tried to place an additional drainage tube in esophagus bed and evaluate its effect in early diagnosis and treatment of AL.Methods: From January 2010 to August 2020, a total of 312 patients, who suffered from esophageal or cardia carcinoma, underwent esophageal resection with intrathoracic esophagogastric anastomosis. Among them, we identified 138 patients with only one pleural drainage tube as “Control Group” and 174 patients with a pleural drainage tube and an additional mediastinal drainage tube (MDT) as “Tube Group”. The incidence of postoperative AL, time to diagnosis, time to recovery, and patient outcome were analyzed.Results: There were no significant differences in the AL rate (P = 0.837) and postoperative pain between two groups. However, in the Tube Group, almost all the patients were definitely diagnosed prior to the appearance of hyperpyrexia, which was regarded as the earliest and most common symptom after AL. Moreover, in the Tube Group, there was significant decrease in the incidence of uncurable fistula, which required re-operation or variable treatments under gastroscopy, when compared to the Control Group (P = 0.032). Finally, patients in the Tube Group were associated with reduced post AL hospital day (P = 0.015) and lower mortality, although there was no significant difference (P = 0.188), than in the Control Group.Conclusions: Placement of a MDT can not prevent the AL, but it is an effective method to diagnose AL earlier and facilitate the fistula healing and patient recovery.
Application of Mediastinal Drainage Tube in Intrathoracic Esophageal Anastomotic Leakage for Early Diagnosis and Effective Treatment: A Retrospective Study
