BACKGROUND: Anastomotic leaks are a major complication of oesophagogastric surgery. We compare contrast swallow fluoroscopy, computed tomography (CT) with oral contrast and endoscopy in identifying anastomotic leaks following oesophagogastric surgery. METHODS: A prospective trial of 38 patients undergoing oesophagogastric resection was undertaken with informed consent and institutional review board (ethics committee) approval. Patients underwent all three investigations (over 24 hours) 1 week postoperatively. RESULTS: Eight (21%) had clinically apparent leaks. Three pseudo-leaks were suggested on contrast swallow but were confirmed normal on CT and endoscopy. Contrast swallow and CT missed one anastomotic leak each. Endoscopy identified anastomotic defects in three patients, in whom CT and contrast swallow were either normal or conflicting. CONCLUSIONS: Routine tests of anastomotic integrity are unnecessary. When clinically suspected, contrast swallow or CT with oral contrast will identify most leaks. Endoscopy is useful in cases where there are incongruous results.
BACKGROUND:Anastomotic leaks are a major complication of oesophagogastric surgery. We compare contrast swallow fluoroscopy, computed tomography (CT) with oral contrast and endoscopy in identifying anastomotic leaks following oesophagogastric surgery. METHODS: A prospective trial of 38 patients undergoing oesophagogastric resection was undertaken with informed consent and institutional review board (ethics committee) approval. Patients underwent all three investigations (over 24 hours) 1 week postoperatively. RESULTS: Eight (21%) had clinically apparent leaks. Three pseudo-leaks were suggested on contrast swallow but were confirmed normal on CT and endoscopy. Contrast swallow and CT missed one anastomotic leak each. Endoscopy identified anastomotic defects in three patients, in whom CT and contrast swallow were either normal or conflicting. CONCLUSIONS: Routine tests of anastomotic integrity are unnecessary. When clinically suspected, contrast swallow or CT with oral contrast will identify most leaks. Endoscopy is useful in cases where there are incongruous results.
Authors: P Honkoop; P D Siersema; H W Tilanus; L P Stassen; W C Hop; M van Blankenstein Journal: J Thorac Cardiovasc Surg Date: 1996-06 Impact factor: 5.209
Authors: Anja Schaible; Peter Sauer; Werner Hartwig; Thilo Hackert; Ulf Hinz; Boris Radeleff; Markus W Büchler; Jens Werner Journal: Surg Endosc Date: 2014-02-12 Impact factor: 4.584