FREQUENCY ANALYSIS OF CERVICAL ESOPH-AGO-ORGAN ANASTOMOTIC LEAK IN ESOPH-AGOPLASTY

The article is devoted to analysis of frequency of cervical esophagus-organ anastomotic leak in esophagoplasty. Gullet operations are associated with high rate of postoperative complications and mortality, reaching 15 % and over. The aim of the study was to improve the results of surgical treatment in patients with corrosive strictures of the esophagus by analyzing frequency of cervical esophagus-organ anastomotic leak and determining the ways of their prevention. The results of surgical treatment in 115 patients with esophageal strictures between 2003 and 2017 were analyzed. The causes of corrosive strictures were: post burn strictures - in 45 patients, postoperative strictures - in 17, peptic strictures - in 10, leiomyoma - in 8 and esophageal cancer - in 35. In the clinic, esophageal replacement with the stomach was performed in 59 patients and that with the colon segment – in 51 patients. Esophagoplasty with the stomach was performed using original elongation of gastric tube. The following types of anastomoses were applied: apparatus anastomosis - in nine patients, invagination anastomosis end-to-end - in 19 and end-to-side anastomosis - in 31patients. Cervical anastomotic leak occurred in 13 patients (22.03%). Colon patch esophagoplasty was performed predomi-nantly with the colon segment consisting partially of ascending, transverse and descending colon with preservation of blood supply due to the left colic artery by the clinic technique. Circular stapler in 10 patients, end-to-side anastomosis – formed cervical anastomosis in 31 and invagination anastomosis end-to-end – in 10 patients. Cervical anastomotic leak was observed in eight patients. That is, cervical anastomotic leak is observed signifi-cantly more frequently in esophagoplasty with gastric tube than in cases using colon segment as a transplant. But using mechanical suture in formation of cervical esophagus-organ anastomosis, cervical anastomotic leak occurs in significantly lower number of patients (5.26 %).