Enthusiasm for minimally invasive esophagectomy is increasing. When feasible, the laparoscopic and thoracoscopic Ivor Lewis esophagogastrectomy with construction of an intrathoracic anastomosis is favored. A potential catastrophic consequence of an intrathoracic anastomosis is a postoperative leak. In this review, the authors summarize the current understanding of the pathophysiology and the management of intrathoracic leak using minimally invasive surgical techniques.
Iannettoni MD , Whyte RI, Orringer MBCatastrophic complications of the cervical esophagogastric anastomosis. J Thorac Cardiovasc Surg.1995;110:1493-1500.
2.
Korst RJ, Port JL, Lee PC, Altorki NKIntrathoracic manifestations of cervical anastomotic leaks after transthoracic esophagectomy for carcinoma. Ann Thorac Surg.2005;80:1185-1190.
3.
Boyle MJ, Franceschi D., Livingstone ASTranshiatal versus transthoracic esophagectomy: complication and survival rates. Am Surg.1999;65:1137-1141.
4.
DePaula AL, Hashiba K., Ferreira EA, de Paula RA, Grecco E.Laparoscopic transhiatal esophagectomy with esophagogastroplasty. Surg Laparosc Endosc. 1995;5:1-5.
5.
Luketich JD, Nguyen NT, Weigel T., Ferson P., Keenan R., Schauer P.Minimally invasive approach to esophagectomy. J Soc LaparoendoscSurg.1998;2:243-247.
Nguyen NT, Follette DM, Lemoine PH, Roberts PF, Goodnight JEMinimally invasive Ivor Lewis esophagectomy. Ann Thorac Surg.2001;72:593-596.
8.
Bizekis C., Kent MS, Luketich JD, et al. Initial experience with minimally invasive Ivor Lewis esophagectomy . Ann Thorac Surg.2006;82:402-406.
9.
Nguyen NT, Longoria M., Chang K., et al. Thoracolaparoscopic modification of the Ivor Lewis esophagogastrectomy. J GastrointestSurg.2006;10:450-454.
10.
Nguyen NT, Follette DM, Roberts PF, et al. Thoracoscopic management of postoperative esophageal leak. J Thorac Cardiovasc Surg.2001;121:391-392.
11.
Martin LW, Swisher SG, Hofstetter W., et al. Intrathoracic leaks following esophagectomy are no longer associated with increased mortality. Ann Surg.2005;242:392-399.
12.
Crestanello JA, Deschamps C., Cassivi SD, et al. Selective management of intrathoracic anastomotic leak after esophagectomy. J Thorac Cardiovasc Surg.2005; 129:254-260.
13.
Maish MS, DeMeester SR, Choustoulakis E., et al. The safety and usefulness of endoscopy for evaluation of the graft and anastomosis early after esophagectomy and reconstruction. Surg Endosc. 2005;19:1093-1102.
14.
Peters JH, Craanen ME, van der Peet DL, et al. Self-expanding metal stents for the treatment of intrathoracic esophageal anastomotic leaks following esophagectomy. Am J Gastroenterol.2006;101:1393-1395.
15.
Schubert D. , Scheidback H., Kuhn R., et al. Endoscopic treatment of thoracic esophageal anastomotic leaks by using silicone-covered, self-expanding polyester stents . Gastrointest Endosc.2005;61:891-896.
16.
Langer FB, Wenzl E., Prager Z., et al. Management of postoperative esophageal leaks with the Polyflex self-expanding covered plastic stent. Ann Thorac Surg.2005;79:398-403.
