CONSERVATIVE MANAGEMENT OF ESOPHAGEAL LEAKS BY TRANSLUMINAL ENDOSCOPIC DRAINAGE OF THE MEDIASTINUM OR PLEURAL SPACE

Background. The management of postoperative leaks into the mediastinum or pleural cavities after esophageal surgery yields unsatisfactory re sults. A recently described method drainage of the mediastinum or pleu ral cavity through suture line defects, has been used in our departmen t with eight patients. Methods. A suction tube was advanced over an en doscopically placed guide wire into the abscess from inside the esopha gus, and tie aspiration was used to remove saliva and secretions. Intr avenous antibiotics and total parenteral nutrition were also given. Re sults. The sepsis was rapidly controlled and the abscess cavity progre ssively collapsed in all cases. Seven patients recovered and were disc harged 34 to 61 days after operation; one died of concomitant complica tions. C onclusions. This method seems promising for the management of intrathoracic esophageal leaks.