Cervical anastomosis in the surgery of the esophagus cancer
The standard care of patients with cancer of the esophagus still remains surgery. One of the most feared complications after such procedure is anastomotic leak. Between 1997 – 2005 we treated 127 patients with esophageal cancer. The rate of resecability was 68,5%, 87 patients underwent segmentary esophagus resection or total esophagectomy and reconstruction by stomach or colon. In 10 unresecable cases a retrosternal esophageal bypass with stomach was carried out. In total 82 patients underwent cervical anastomosis. In the postoperative period in 13 cases appeared cervical fistula; in 8 cases the fistulas were small, with spontan healing by local and conservativ treatment. 5 patients with large fistula required reoperation: in 2 cases temporary jejunostomy, in other 2 cases permanent jejunostomy and esophagostomy; in one case a new esogastric anastomosis was performed. Most common causes of fistula are technical problems, ischemic gastric or colonic tube and postoperativ respiratory disorder.