초록접수 현황
| 17F-059 | 구연 발표 |
Postoperative Endoscopy for the Evaluation of Local Complications after Esophagectomy.
Jae Hyun Jeon, Da Na Moon, Hee Chul Yang, Moon Soo Kim, Jong Mog Lee
Center for Lung Cancer, National Cancer Center, Gyeonggi-do, Republic of Korea
Purpose : Anastomotic leaks are serious complications after esophagectomy. Early diagnosis and intervention can reduce the morbidity associated with this condition but is hindered by current diagnostic methods that are uninformative. The aim of this study was to assess diagnostic usefulness of routine endoscopy for the evaluation of the graft and anastomosis after esophagectomy.
Methods : Data were obtained from 211 patients who underwent esophagectomy and reconstruction with a gastric tube between May 2010 and October 2015. All patients underwent early endoscopy in the first week after esophagectomy. The anastomosis and gastric mucosa were examined for evidence of ulceration, ischemia, necrosis, and leak.
Results : Routine endoscopy was performed a median of 6 days (range, 5-7 days) after operation, and there were no complications or anastomotic injuries associated with endoscopy. The anastomotic leak rate was 5.2 % (11 of 211 patients), and reoperation was necessary in three of these patients. Other pathologic findings were observed in 38 patients (18.0%); deep ulceration in 22 patients, graft ischemia in 14, and graft necrosis in 2. These 38 patients with abnormal pathologic findings were monitored with a repeat endoscopy after a further week; a delayed leak was found in seven of these patients (18.4%). In contrast, no delayed leak occurred in any of 162 patients who had a healthy graft on routine endoscopy (p < 0.001).
Conclusion : Endoscopic evaluation within 1 week of esophagectomy is a safe and accurate method for detecting anastomotic leak. It also provides unique information on the condition of the graft, which predicts delayed anastomotic leak.
Methods : Data were obtained from 211 patients who underwent esophagectomy and reconstruction with a gastric tube between May 2010 and October 2015. All patients underwent early endoscopy in the first week after esophagectomy. The anastomosis and gastric mucosa were examined for evidence of ulceration, ischemia, necrosis, and leak.
Results : Routine endoscopy was performed a median of 6 days (range, 5-7 days) after operation, and there were no complications or anastomotic injuries associated with endoscopy. The anastomotic leak rate was 5.2 % (11 of 211 patients), and reoperation was necessary in three of these patients. Other pathologic findings were observed in 38 patients (18.0%); deep ulceration in 22 patients, graft ischemia in 14, and graft necrosis in 2. These 38 patients with abnormal pathologic findings were monitored with a repeat endoscopy after a further week; a delayed leak was found in seven of these patients (18.4%). In contrast, no delayed leak occurred in any of 162 patients who had a healthy graft on routine endoscopy (p < 0.001).
Conclusion : Endoscopic evaluation within 1 week of esophagectomy is a safe and accurate method for detecting anastomotic leak. It also provides unique information on the condition of the graft, which predicts delayed anastomotic leak.
책임저자: Jong Mog Lee
Center for Lung Cancer, National Cancer Center, Gyeonggi-do, Republic of Korea
발표자: Jae Hyun Jeon, E-mail : jhjeon@ncc.re.kr