A 28 years review of postoperative anastomotic leakage of esophageal and Cardiac cancer(A report of 111 cases)

Objective To explore the preventive and therapeutic methods of postoperative anastomotic leakage of esophageal and cardial carcinoma.Method From January 1977 to December 2004,5402 cases of surgical resections of esophageal and cardial carcinoma were reviewed and were divided into 2 groups. 3785 cases from Jan, 1977 to Dec, 1995 were included in group A and 1617 cases from Jan, 1996 to Dec, 2004 were included in group B. Postoperative anastomostic leakage were compared between the two groups. Results The total anastomotic leakage was 2.1%(111/5402), the total mortality of anastomotic leakage was 27.9%(31/111). In group A, the anastomotic leakage rate was 2.2%(83/3785), the mortality of anastomotic leakage was 34.9%(29/83). In group B, the anastomotic leakage rate was 1.7%(28/1617), the mortality of anastomotic leakage was 7.1%(2/28). The anastomotic leakage mortality of group B was significantly lower than that group A(P 0.01). The intrathoracic anastomotic leakage of group B was significantly lower than group A(P 0.01). Conclusion It is very important to improve anastomotic technique,early diagnosis of anastomotic leakage and early active management for preventive and therapeutic postoperative anastomotic leakage of esophageal and cardiac cancer.