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Treatment of Esophageal Anastomotic Leakages after Cancer Resection. The Role of Total Parenteral Nutrition
Author(s) -
Riboli E. Berti,
Bertoglio S.,
Arnulfo G.,
Terrizzi A.
Publication year - 1986
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/014860718601000182
Subject(s) - medicine , parenteral nutrition , anastomosis , surgery , mediastinitis , complication , incidence (geometry) , esophageal cancer , respiratory failure , esophagectomy , cancer , physics , optics
A series of 16 cases of esophageal anastomotic leakages after cancer resection observed from 1978 to 1982 is analyzed in a retrospective manner. Eight patients related to the period 1978 to 1980 (series A) were treated with emergency surgery while the remaining eight patients observed from 1980 to 1982 (series B) were treated conservatively with total parenteral nutrition (TPN) and complete fasting. Seven patients from series A eventually died postoperatively and one patient had a good recovery after emergency reintervention. In the series B six patients left the hospital with complete healing of the anastomotic leaks after 27.2 ± 13.5 days of TPN and complete fasting, while failure of the treatment was observed in two patients who died from septic mediastinitis and acute respiratory failure. Different incidence of positive clinical results in Series A and B was statistically significant ( p < 0.01). The role of TPN and complete fasting will be discussed as the primary approach for the management of this severe complication, taking in consideration the suture line drainage and the control of infection. ( Journal of Parenteral and Enteral Nutrition 10: 82–85, 1986)