Treatment of intrathoracic anastomotic leakage following surgery for esophageal cancer and cardia cancer

Objective:To explore the treatment of anastomotic leakage after surgical operation for sophageal cancer and cardia cancer.Methods:Twenty-one of them received double-tube full drainage,empyema control,treatment for respiratory failure,nutritional support and other conservative therapies;4 of them underwent a second thoracotomy and catheter drainage for abscess cleaning,and 1 of them received a second thoracotomy and re-anastomosis in the neck after resection of the original anastomosis;7 cases were placed titanium-nickel-memory alloy covered esophageal stent,3 of whom had undergone a second thoracotomy and catheter drainage.Results:Twenty-one cases were cured;the postoperative hospital stay was 26 to 73 days,including 3 patients who had received a second thoracotomy,catheter drainage and esophageal stent implantation.Five died.The causes of death were respiratory failure and toxic shock due to uncontrolled infection.Conclusions:Proper selection and improved procedures can improve the clinical efficacy on intrathoracic anastomotic leakage.The procedure of secondary thoracotomy tube drainage and esophageal stent placement is worth investigating.