Our Summary

This study looked at how to monitor and better understand a common complication that can occur during surgery to remove part of the esophagus - a tube that connects the throat to the stomach. This complication, known as an anastomotic leak, is when the place where the surgeon connected the remaining parts of the esophagus and stomach together doesn’t hold.

A total of 25 patients undergoing this kind of surgery were included in the study. The researchers used a special device to measure levels of a chemical called lactate on both sides of the connection point. High lactate levels can be a sign of problems like anastomotic leaks.

This device was used to take measurements every half an hour for the first day after surgery, and then every two hours for up to four days. The device worked as planned in almost all cases, and was able to keep taking measurements for three days in most patients.

The researchers found that in cases where an anastomotic leak did occur, there were high lactate levels on the stomach side of the connection. This suggests that this method could be a useful way to detect problems early and improve patient care after this type of surgery. The researchers concluded that using this device and method is feasible and safe.

FAQs

  1. What is an anastomotic leak in the context of esophagectomy surgery?
  2. How can high lactate levels indicate an anastomotic leak?
  3. How often and for how long was the special device used to monitor lactate levels after surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about esophagectomy is to be aware of the signs and symptoms of an anastomotic leak, such as fever, chest pain, difficulty breathing, or abdominal pain. It’s important to report any of these symptoms to your healthcare team immediately so that any potential complications can be addressed promptly. Additionally, following post-operative care instructions, attending follow-up appointments, and maintaining a healthy diet and lifestyle can help promote a successful recovery after surgery.

Suitable For

Esophagectomy is typically recommended for patients with conditions such as esophageal cancer, Barrett’s esophagus with high-grade dysplasia, severe esophageal strictures, or other conditions that affect the esophagus. Patients who have not responded to other treatments or who have a high risk of developing complications from their condition may also be recommended for esophagectomy.

Timeline

Before the esophagectomy, the patient will undergo pre-operative evaluations, such as imaging tests and blood work, to assess their overall health and suitability for surgery. The patient will also meet with the surgical team to discuss the procedure and potential risks and benefits.

During the esophagectomy surgery, the surgeon will remove part of the esophagus and connect the remaining parts of the esophagus and stomach together. The surgery can be done through open surgery or minimally invasive techniques.

After the esophagectomy, the patient will typically spend several days in the hospital recovering. They may have a temporary feeding tube to help with nutrition while their digestive system heals. The patient will also need to follow a strict diet and avoid certain activities to prevent complications.

In the weeks and months following the esophagectomy, the patient will have follow-up appointments with their surgical team to monitor their recovery and address any concerns. The patient may also need to undergo additional treatments, such as chemotherapy or radiation therapy, depending on the underlying condition that led to the need for surgery.

Overall, the recovery process after esophagectomy can be challenging, but with proper care and support, most patients can regain their strength and quality of life.

What to Ask Your Doctor

  1. What is the likelihood of experiencing an anastomotic leak after esophagectomy surgery?
  2. How will my healthcare team monitor for signs of anastomotic leak post-surgery?
  3. What are the symptoms of an anastomotic leak that I should watch out for?
  4. How soon after surgery can an anastomotic leak typically occur?
  5. If an anastomotic leak is detected, what treatment options are available?
  6. How does the measurement of lactate levels help in detecting anastomotic leaks?
  7. What are the risks associated with using the device to measure lactate levels post-surgery?
  8. How often will lactate levels be monitored using the device in the post-operative period?
  9. How does early detection of anastomotic leaks impact the overall success of the surgery and recovery process?
  10. Are there any specific dietary or lifestyle changes I should make to reduce the risk of anastomotic leaks after surgery?

Reference

Authors: Hedberg J, Linder G, Sundbom M. Journal: Esophagus. 2021 Oct;18(4):783-789. doi: 10.1007/s10388-021-00846-w. Epub 2021 May 29. PMID: 34052933