Academic Journal of Second Military Medical University (第二军医大学学报) 2015/36:12 PP.1356-1359
Objective To evaluate the efficacy and safety of presetting negative pressure drainage for anastomotic leakage after esophageal cancer surgery. Methods The clinical data of 68 patients with intrathoracic anastomotic leakage following surgery of esophageal and cardial carcinoma from January 2008 and January 2014 were retrospectively analyzed The patients were divided into 3 groups, including presetting negative pressure drainage group (Group A), endoscopy drainage placement group (Group B) and traditional treatment group (Group C ). Results A total of 1 251 patients underwent intrathoracic anastomosis were analyzed and anastomotic leakage occurred in 68 cases (5.4%), with 14(20.6%) died after operation. The mortality rates of Group A and Group B were significantly lower than that in Group C (14.3%, 0 vs 39.1%,P<0.05). The repeated drainage times in Group A and Group B were signficantly less than that in Group C (P<0.05). Compared with Group B and Group C, Group A had the advantage of shorter manipulation time (P<0.05). Drainage lavaging time, recovery time and retaining time of gastric tube in Group A and Group B were significantly shorter than those in Group C(P<0.05). Patients in Group A and Group C had significantly less discomfort in nasopharynx and significantly lower obstruction incidence compared with those in Group B (P<0.05). Except for death, all patients with anastomotic leakage had normal diet and safe discharge after prompt treatment. Conclusion Presetting negative pressure drainage after esophageal cancer surgery has a better effect for anastomotic leakage by reducing recovery time, lowering mortality rate and alleviating the suffering of patients.
 Kassis E S, Kosinski A S, Ross P Jr, Koppes K E, Donahue J M, Daniel V C. Predictors of anastomotic leak after esophagectomy: an analysis of the society of thoracic surgeons general thoracic database[J].Ann Thorac Surg, 2013, 96:1919-1926.
 Honda M, Kuriyama A, Noma H, Nunobe S, Furukawa T A. Hand-sewn versus mechanical esophagogastric anastomosis after esophagectomy: a systematic review and meta-analysis[J]. Ann Surg, 2013, 257: 238-248.
 Luechakiettisak P, Kasetsunthorn S. Comparison of hand-sewn and stapled in esophagogastric anastomosis after esophageal cancer resection: a prospective randomized study[J]. J Med Assoc Thai, 2008, 91: 681-685.
 Zhang Y S, Gao B R, Wang H J, Su Y F, Yang Y Z, Zhang J H, et al. Comparison of anastomotic leakage and stricture formation following layered and stapler oesophagogastric anastomosis for cancer: a prospective randomized controlled trial[J].J Int Med Res, 2010, 38: 227-233.
 朱青松, 章焱周, 吕剑剑, 陈业庭, 葛孝忠, 杨 林, 等.瘘腔外引流治疗胃食管吻合口瘘[J].中国胸心血管外科临床杂志, 2012, 19:336-338.
 Tang H, Xue L, Hong J, Tao X, Xu Z, Wu B. A method for early diagnosis and treatment of intrathoracic esophageal anastomotic leakage: prophylactic placement of a drainage tube adjacent to the anastomosis[J].J Gastrointest Surg, 2012, 16:722-727.