G. Chassot et al., PROTECTION OF INTRATHORACIC ANASTOMOSES U SING THE PLEURAL TENT AFTERIVOR-LEWIS ESOPHAGECTOMY, Journal de chirurgie, 134(9-10), 1997, pp. 432-435
Purpose of the study. Description of a technical procedure to diminish
the risk of spillage into mediastinum in case of leakage from an intr
athoracic anastomosis after partial esophagectomy. Method. In Ivor-Lew
is procedures for cancer of the middle or lower third of the esophagus
, the esogastric anastomosis is slipped under the upper mediastinal pl
eura which is kept intact. From 1989 to 1997, this technique has been
used in 43 consecutive patients (squamous carcinoma in 22, adenocarcin
oma in 21). Three patients died postoperatively (7%) and complications
(in 38%) were mostly pulmonary and cardiac. No anastomotic leak was d
etected on routine Gastrographin swallow performed on the 7th postoper
ative day. Three patients required dilation for stenosis. Discussion a
nd conclusion. Subpleural blanketing of intrathoracic anastomoses afte
r esophagectomy is safe and easy to do, and should help diminish the c
onsequences of possible anastomotic leakage.