Introduction Surgery remains the mainstay treatment for localized esophageal squamous cell carcinoma(ESCC).In recent years,three-incision McKeown esophagectomy has been widely applied for operable ESCC considering its...Introduction Surgery remains the mainstay treatment for localized esophageal squamous cell carcinoma(ESCC).In recent years,three-incision McKeown esophagectomy has been widely applied for operable ESCC considering its superiority in acquiring extensive lymphadenectomy and long-termsurvival[1].Cervical anastomotic fistula is one of the most dreaded complications in patients undergoing three-incision esophagectomy;it occurs in almost 10%–25%of patients and is responsible for almost 40%of post-operative deaths[2,3].Most surgeons prefer conservative approaches including perianastomotic drainage,total parenteral nutrition,nasogastric decompression,and the use of broad-spectrum antibiotics for cervical anastomotic fistula[4,5].However,the recovery period under this method is commonly long and unsatisfactory.Until now,the optimal treatment for cervical anastomotic fistula has not yet been established.In this study,we describe a flushingdrainage system under negative pressure conditions to treat cervical anastomotic fistula,named anastomotic vacuum-assisted closure(AVAC).展开更多
基金supported by the National Natural Science Foundation of China[grant number 82102955]the Guangzhou Basic Research Project[grant number 202201011326].
文摘Introduction Surgery remains the mainstay treatment for localized esophageal squamous cell carcinoma(ESCC).In recent years,three-incision McKeown esophagectomy has been widely applied for operable ESCC considering its superiority in acquiring extensive lymphadenectomy and long-termsurvival[1].Cervical anastomotic fistula is one of the most dreaded complications in patients undergoing three-incision esophagectomy;it occurs in almost 10%–25%of patients and is responsible for almost 40%of post-operative deaths[2,3].Most surgeons prefer conservative approaches including perianastomotic drainage,total parenteral nutrition,nasogastric decompression,and the use of broad-spectrum antibiotics for cervical anastomotic fistula[4,5].However,the recovery period under this method is commonly long and unsatisfactory.Until now,the optimal treatment for cervical anastomotic fistula has not yet been established.In this study,we describe a flushingdrainage system under negative pressure conditions to treat cervical anastomotic fistula,named anastomotic vacuum-assisted closure(AVAC).