Clinical Study Of Nose Fistula Tube Drainage Under Gastroscope For Huge Anastomotic Leak In Patients After Resection Of Esophageal Cancer

ObjectiveTo investigate the value of using gastroscope-guided transnasal tube insertion in the treatment of huge anastomotic leak after esophagectomy for esophageal cancer.MethodFrom January 2013 to July 2017,five patients were confirmed huge(diameter?2cm)intrathoracic anastomotic leak among those who were performed surgical operation due to esophageal carcinoma in the First Affiliated Hospital of Chongqing Medical University.The clinical data and the progress of the disease were followed up.The changes of related indexes before and after the drainage were compared,and the outcome after drainage treatment was recorded.ResultsAll patients were successfully implanted nose fistula tube drainage under gastroscope guidance,the body temperature returned to normal within 1?13(6.2±5.1)d,and the white blood cell count returned to normal within 6?15(12.2±3.7)d after treatment.All 5 patients underwent endoscopic transluminal drainage,all survived,and the mean healing time was 41 days.Compared with late drainage,patients of early drainage had a shorter time in chest drainage duration(32.7±1.5d vs 64.5±10.6d),fistula cavity drainage duration(19.0±12.7d vs 45.8±16.1d),gastrointestinal decompression duration(40.3±14.0d vs 74.0±5.7d),fistula healing time(27.3±17.2d vs 61.5±12d),and the hospital duration after confirmation(33.0±13.1dvs73.0±5.7d).ConclusionDrainage of the fistula through the nasal fistula under gastroscope guidance can promote the healing of the huge intrathoracic anastomotic leakage after the operation of esophageal cancer.The early use of the treatment can shorten the patient's recovery time.The drainage is simple,small trauma,low cost,safe and effective,and can be used in clinical promotion.