초록접수 현황
| 15F-223 | 구연 발표 |
Endoscopic V.A.C. Therapy for Postoperative Leakage after Esophageal Resection
Hyo-Jun Jang, M.D.¹, Sungjoon Park, M.D.¹, Kyung wook Shin, M.D.¹, Eunjue Yi, M.D.¹, Sukki Cho, M.D., Ph.D.¹,², Sanghoon Jheon, M.D., Ph.D.¹,², Kwhanmien Kim, M.D., Ph.D¹,²
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Republic of Korea¹, Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea²
Background : Postoperative leakage after esophageal resection is a serious complication with high morbidity and mortality rate. Endoscopic V.A.C. therapy is a novel option for the management of anastomotic leakage after esophageal resection.
Methods : From January 2012 to July 2015, one hundred six cases of esophagectomy were performed by thoracic surgeons in our institution. During the period, ten cases of postoperative leakage were diagnosed. In 2 cases, take-down of graft were performed. In 1 case, V.A.C. therapy on cervical wound was performed. seven cases were managed by endoscopic V.A.C. therapy. In addition, 2 cases of leaks which were operated by general surgeons in our institution and 1 case of leak which was operated at other institution were also managed by endoscopic V.A.C. therapy in our institution. Total 10 cases of endoscopic V.A.C. therapy were reviewed.
Results : Median age was 69.0 years (range, 59-80). eight cases were male. In 2 cases, jejunum was used as conduit and in other 8 cases, stomach was used. Nine cases of leakage were developed in intrathoracic level and 1 case of leak in cervical level. In 5 of 10 cases, the fistula size was more than 2cm. The median duration of therapy was 13.5 days (range, 7-110). In 1 case, ulcer bleeding was developed during endoscopic V.A.C. therapy. There was no mortality during V.A.C. therapy. Complete restoration of the fistula was achieved in 9 of 10 cases (90%). The patient who did not recover from fistula was transferred to other institution during therapy by patient’s request.
Conclusion : Endoscopic V.A.C. therapy showed high success rate. It might be an effective treatment option for postoperative leakage after esophageal resection.
Methods : From January 2012 to July 2015, one hundred six cases of esophagectomy were performed by thoracic surgeons in our institution. During the period, ten cases of postoperative leakage were diagnosed. In 2 cases, take-down of graft were performed. In 1 case, V.A.C. therapy on cervical wound was performed. seven cases were managed by endoscopic V.A.C. therapy. In addition, 2 cases of leaks which were operated by general surgeons in our institution and 1 case of leak which was operated at other institution were also managed by endoscopic V.A.C. therapy in our institution. Total 10 cases of endoscopic V.A.C. therapy were reviewed.
Results : Median age was 69.0 years (range, 59-80). eight cases were male. In 2 cases, jejunum was used as conduit and in other 8 cases, stomach was used. Nine cases of leakage were developed in intrathoracic level and 1 case of leak in cervical level. In 5 of 10 cases, the fistula size was more than 2cm. The median duration of therapy was 13.5 days (range, 7-110). In 1 case, ulcer bleeding was developed during endoscopic V.A.C. therapy. There was no mortality during V.A.C. therapy. Complete restoration of the fistula was achieved in 9 of 10 cases (90%). The patient who did not recover from fistula was transferred to other institution during therapy by patient’s request.
Conclusion : Endoscopic V.A.C. therapy showed high success rate. It might be an effective treatment option for postoperative leakage after esophageal resection.
책임저자: Kwhanmien Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Republic of Korea
연락처 : Hyo-Jun Jang, Tel: 010-6362-6361 , E-mail : rgo38@naver.com
