EXPERIMENTAL ASSESSMENT OF ESOPHAGEAL ANASTOMOTIC INTEGRITY

  • 1 January 1978
    • journal article
    • research article
    • Vol. 146  (4) , 545-550
Abstract
The role of proximal diversion and perioperative antibiotics in primary healing of experimental esophageal anastomoses was studied. The clinical leak and death rate seen in patients treated for carcinoma of the esophagus was simulated using 34 cats which underwent partial thoracic esophagectomy with end-to-end anastomosis, Seventeen cats were randomized to complementary proximal esophageal diversion. Postoperative mortality was 38%. The over-all rate of anastomotic leakage was 18%, with 83% of the cats dying as a result of this complication. Proximal esophageal diversion had no demonstrable role in the prevention of anastomotic dehiscence or subsequent mortality. In 22 of 34 cats, systemic perioperative antibiotics were administered. Administration of perioperative antibiotics decreased anastomotic leak significantly, P < 0.05, and lowered mortality, P < 0.001, with or without proximal esophageal diversion.

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