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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2011

01-12-2011 | Thoracic Oncology

Modified Pleural Tenting for Prevention of Anastomotic Leak After Ivor Lewis Esophagogastrectomy

Authors: Christos Asteriou, MD, MSc, Nikolaos Barbetakis, MD, PhD, Miltiadis Lalountas, MD, MSc, Athanassios Kleontas, MD, Christodoulos Tsilikas, MD, PhD

Published in: Annals of Surgical Oncology | Issue 13/2011

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Abstract

Background

The most dangerous complication following esophagogastrectomy for esophageal cancer is anastomotic leakage. Surgical interventions described did not have a major impact in reducing the risk of occurrence. On the other hand, pleural tenting has been used for more than a decade by thoracic surgeons to prevent prolonged air leak after formal upper lobectomy with excellent results.

Methods

A retrospective analysis of 114 cases of esophagogastrectomy for cancer of esophagus or cardioesophageal junction is presented. Patients have been divided in 2 groups. In group B modified pleural tenting was used to prevent a potential anastomotic leak, while in group A, the control group, pleural tenting was not used. Evaluation of modified pleural tenting in preventing anastomotic leakage was the aim of the study.

Results

The pleural tenting group showed a significant decrease in anastomotic leak. In 1 patient versus 8 in group without pleural tenting the complication appeared (P = .032). The risk for an anastomotic leakage in group without pleural tenting was almost 9 times greater (odds ratio: 9.143, 95% confidence interval: lower bound 1.104, upper bound 75.708). The 30-day mortality, although lower in pleural tenting group, was not statistically significant.

Conclusions

Pleural tenting is a safe, fast, and effective technique for prevention of anastomotic leakage after Ivor Lewis esophagogastrectomy. Subpleural blanketing of intrathoracic anastomosis could diminish the consequences of a possible anastomotic leak.
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Metadata
Title
Modified Pleural Tenting for Prevention of Anastomotic Leak After Ivor Lewis Esophagogastrectomy
Authors
Christos Asteriou, MD, MSc
Nikolaos Barbetakis, MD, PhD
Miltiadis Lalountas, MD, MSc
Athanassios Kleontas, MD
Christodoulos Tsilikas, MD, PhD
Publication date
01-12-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 13/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-1835-8

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