Esophageal Leak And Rupture
Esophageal leaks and ruptures are common complications following esophageal resection for the treatment of esophageal carcinoma. The incidence of anastomotic leaks in the thoracic region is 3-25%, with a mortality rate of 30-60%. These leaks can be classified into different grades based on their severity. The etiology of anastomotic leaks is multifactorial, with factors such as preoperative malnutrition, diabetes mellitus, hypotension, and hypoxemia contributing to their development. Surgical and technical aspects also play a role in the occurrence of leaks, with higher tension in the cervical region increasing the risk. Various surgical techniques, such as staplers and different suture techniques, can be used to perform the anastomosis. Supporting the anastomosed region with omentum, pleura, pericardium, and fat tissue can help reduce the incidence of leaks. Overall, the treatment of esophageal leaks and ruptures is controversial, and there is no standardized treatment algorithm. However, the use of self-expandable coated metallic stents has shown promising results in the management of thoracic anastomotic leaks.(AI)
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