Cervical anastomosis in the surgery of the esophagus cancer

Written by Török Árpád, Bancu Şerban, Bara Tivadar, Butiurca Sándor, Dénes Márton, György-Fazakas István

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.

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