الفهرس 
Anatomy of the OesophagusOnly 14 pages are availabe for public view
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Abstract
Esophagectomy is needed for a variety of esophageal disorders, the most common indication is cancer esophagus, however, it is needed in benign disorders as postcorrosive strictures & endstage achalasia with esophageal dilatation.
Anastomotic leakage is one of the most severe complications leading to significant morbidity and increased risk of mortality.
Leaks after esophagectomy have different manifestations and vary in clinical presentations & complications, ranging from local wound infections to life threatening sepsis.
Cervical leaks have higher incidence than their thoracic counterparts, but their clinical impact is less critical, because of the extra thoracic location without connection to the mediastinum.
Most of the leaks develop within 10 days following surgery.
Diagnosis of anastomotic leakage after esophagectomy can be difficult. Most surgeons use a contrast swallow routinely for patients within 1 week of the operation to confirm anastomotic healing then the patient is allowed to resume swallowing. Others rely on gradual introduction of oral fluids and solids with close clinical monitoring and only request the contrast swallow if leakage is suspected.
Several diagnostic modalities are available for Anastomotic leakage detection, including contrast swallow examination, computed tomography (CT) scan, and endoscopy.
Initial radiographic contrast swallow examination may fail to diagnose many of these leaks.
The management of anastomotic leaks is often selective based on patients’ clinical condition, site of leak, and extent of leak.
Early identification of leaks provides the best chance to minimize morbidity and mortality from this complication.
While some anastomotic leakages can be managed with conservative treatment including nil per os [NPO], antibiotics, gastric drainage, enteral or parenteral feeding, and percutaneous thoracic drainage, other anastomotic leaks need interventions such as endoscopic stent placement, endoscopic vacuum-assisted closure devices, or surgery.
A key issue is that there is no uniform method for treating patients with symptomatic postesophagectomy leakage.