Skip to main content
SpringerLink
Log in

Prevention and Treatment of Major Complications After Esophageal Surgery

  • Chapter
  • First Online:
Book cover Treatment of Postoperative Complications After Digestive Surgery

Abstract

Esophageal carcinoma is an aggressive disease with early lymphatic and hematogenous dissemination. The incidence of esophageal carcinoma has been rising steadily over the past decades due to the increasing number of patients with distal esophageal and gastroesophageal junction adenocarcinoma. Despite a reduced risk of esophagectomy due to centralization of surgery, the use of neoadjuvant treatments, advances in surgical techniques, and improvements in perioperative care, esophageal surgery is still associated with substantial morbidity. This chapter will discuss the incidence, diagnosis, and treatment of the most important nonsurgical and surgical complications associated with surgical resection of the esophagus. In addition, minimally invasive esophageal surgery will be discussed followed by esophageal surgery for benign disease.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Pohl H, Welch HG. The role of overdiagnosis and reclassification in the marked increase of esophageal adenocarcinoma incidence. J Natl Cancer Inst. 2005;97(2):142–6.

    Article  PubMed  Google Scholar 

  2. Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol. 2006;24(14):2137–50.

    Article  PubMed  Google Scholar 

  3. Hulscher JB, van Sandick JW, Tijssen JG, Obertop H, van Lanschot JJ. The recurrence pattern of esophageal carcinoma after transhiatal resection. J Am Coll Surg. 2000;191(2):143–8.

    Article  PubMed  CAS  Google Scholar 

  4. Mariette C, Balon JM, Piessen G, Fabre S, Van Seuningen I, Triboulet JP. Pattern of recurrence following complete resection of esophageal carcinoma and factors predictive of recurrent disease. Cancer. 2003;97(7):1616–23.

    Article  PubMed  Google Scholar 

  5. Hulscher JB, van Sandick JW, de Boer AG, Wijnhoven BP, Tijssen JG, Fockens P, et al. Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the esophagus. N Engl J Med. 2002;347(21):1662–9.

    Article  PubMed  Google Scholar 

  6. Omloo JM, Lagarde SM, Hulscher JB, Reitsma JB, Fockens P, van Dekken DH, et al. Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the mid/distal esophagus: five-year survival of a randomized clinical trial. Ann Surg. 2007;246(6):992–1000.

    Article  PubMed  Google Scholar 

  7. Wu PC, Posner MC. The role of surgery in the management of oesophageal cancer. Lancet Oncol. 2003;4(8):481–8.

    Article  PubMed  Google Scholar 

  8. Swisher SG, Deford L, Merriman KW, Walsh GL, Smythe R, Vaporicyan A, et al. Effect of operative volume on morbidity, mortality, and hospital use after esophagectomy for cancer. J Thorac Cardiovasc Surg. 2000;119(6):1126–32.

    Article  PubMed  CAS  Google Scholar 

  9. Wouters MW, Wijnhoven BP, Karim-Kos HE, Blaauwgeers HG, Stassen LP, Steup WH, et al. High-volume versus low-volume for esophageal resections for cancer: the essential role of case-mix adjustments based on clinical data. Ann Surg Oncol. 2008;15(1):80–7.

    Article  PubMed  Google Scholar 

  10. van Heijl M, van Lanschot JJ, Blom RL, Bergman JJ, Ten Kate FJ, Busch OR, et al. Outcomes of 16 years of oesophageal surgery: low postoperative mortality and improved long-term survival. Ned Tijdschr Geneeskd. 2010;154:A1156.

    PubMed  Google Scholar 

  11. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.

    Article  PubMed  Google Scholar 

  12. Lagarde SM, Reitsma JB, Maris AK, van Berge Henegouwen MI, Busch OR, Obertop H, et al. Preoperative prediction of the occurrence and severity of complications after esophagectomy for cancer with use of a nomogram. Ann Thorac Surg. 2008;85(6):1938–45.

    Article  PubMed  Google Scholar 

  13. Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, et al. The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med. 1994;149(3 Pt 1):818–24.

    Article  PubMed  CAS  Google Scholar 

  14. Zingg U, Smithers BM, Gotley DC, Smith G, Aly A, Clough A, et al. Factors associated with postoperative pulmonary morbidity after esophagectomy for cancer. Ann Surg Oncol. 2011;18(5):1460–8.

    Article  PubMed  Google Scholar 

  15. Schoppmann SF, Prager G, Langer FB, Riegler FM, Kabon B, Fleischmann E, et al. Open versus minimally invasive esophagectomy: a single-center case controlled study. Surg Endosc. 2010;24(12):3044–53.

    Article  PubMed  Google Scholar 

  16. Zingg U, McQuinn A, DiValentino D, Esterman AJ, Bessell JR, Thompson SK, et al. Minimally invasive versus open esophagectomy for patients with esophageal cancer. Ann Thorac Surg. 2009;87(3):911–9.

    Article  PubMed  Google Scholar 

  17. Tisdale JE, Wroblewski HA, Wall DS, Rieger KM, Hammoud ZT, Young JV, et al. A randomized, controlled study of amiodarone for prevention of atrial fibrillation after transthoracic esophagectomy. J Thorac Cardiovasc Surg. 2010;140(1):45–51.

    Article  PubMed  CAS  Google Scholar 

  18. Malhotra SK, Kaur RP, Gupta NM, Grover A, Ramprabu K, Nakra D. Incidence and types of arrhythmias after mediastinal manipulation during transhiatal esophagectomy. Ann Thorac Surg. 2006;82(1):298–302.

    Article  PubMed  Google Scholar 

  19. Nattel S. New ideas about atrial fibrillation 50 years on. Nature. 2002;415(6868):219–26.

    Article  PubMed  CAS  Google Scholar 

  20. Murthy SC, Law S, Whooley BP, Alexandrou A, Chu KM, Wong J. Atrial fibrillation after esophagectomy is a marker for postoperative morbidity and mortality. J Thorac Cardiovasc Surg. 2003;126(4):1162–7.

    Article  PubMed  Google Scholar 

  21. Walther B, Johansson J, Johnsson F, Von Holstein CS, Zilling T. Cervical or thoracic anastomosis after esophageal resection and gastric tube reconstruction: a prospective randomized trial comparing sutured neck anastomosis with stapled intrathoracic anastomosis. Ann Surg. 2003;238(6):803–12.

    Article  PubMed  Google Scholar 

  22. Boone J, Livestro DP, Elias SG, Borel Rinkes IH, Van HR. International survey on esophageal cancer: part I surgical techniques. Dis Esophagus. 2009;22(3):195–202.

    Article  PubMed  Google Scholar 

  23. van Heijl M, van Wijngaarden AK, Lagarde SM, Busch OR, van Lanschot JJ, van Berge Henegouwen MI. Intrathoracic manifestations of cervical anastomotic leaks after transhiatal and transthoracic oesophagectomy. Br J Surg. 2010;97(5):726–31.

    Article  PubMed  Google Scholar 

  24. Urschel JD, Blewett CJ, Bennett WF, Miller JD, Young JE. Handsewn or stapled esophagogastric anastomoses after esophagectomy for cancer: meta-analysis of randomized controlled trials. Dis Esophagus. 2001;14(3–4):212–7.

    Article  PubMed  CAS  Google Scholar 

  25. Boone J, Rinkes IB, van Leeuwen M, van Hillegersberg R. Diagnostic value of routine aqueous contrast swallow examination after oesophagectomy for detecting leakage of the cervical oesophagogastric anastomosis. ANZ J Surg. 2008;78(9):784–90.

    Article  PubMed  Google Scholar 

  26. Low DE. Diagnosis and management of anastomotic leaks after esophagectomy. J Gastrointest Surg. 2011;15:1319–22.

    Google Scholar 

  27. Lagarde SM, Omloo JM, de Jong K, Busch OR, Obertop H, van Lanschot JJ. Incidence and management of chyle leakage after esophagectomy. Ann Thorac Surg. 2005;80(2):449–54.

    Article  PubMed  Google Scholar 

  28. Omloo JM, Lagarde SM, Vrouenraets BC, Busch OR, van Lanschot JJ. Compartimentalization for chylothorax originating from the abdomen after extended esophagectomy. Report of two cases and review of the literature. Dig Surg. 2006;23(1–2):86–92.

    Article  PubMed  CAS  Google Scholar 

  29. Gelpke H, Grieder F, Decurtins M, Cadosch D. Recurrent laryngeal nerve monitoring during esophagectomy and mediastinal lymph node dissection. World J Surg. 2010;34(10):2379–82.

    Article  PubMed  Google Scholar 

  30. Gockel I, Kneist W, Keilmann A, Junginger T. Recurrent laryngeal nerve paralysis (RLNP) following esophagectomy for carcinoma. Eur J Surg Oncol. 2005;31(3):277–81.

    Article  PubMed  CAS  Google Scholar 

  31. Bakhos C, Alazemi S, Michaud G, DeCamp MM. Staged repair of benign tracheo-neo-esophageal fistula 12 years after esophagectomy for esophageal cancer. Ann Thorac Surg. 2010;90(6):e83–5.

    Article  PubMed  Google Scholar 

  32. Buskens CJ, Hulscher JB, Fockens P, Obertop H, van Lanschot JJ. Benign tracheo-neo-esophageal fistulas after subtotal esophagectomy. Ann Thorac Surg. 2001;72(1):221–4.

    Article  PubMed  CAS  Google Scholar 

  33. van Heijl M, Gooszen JA, Fockens P, Busch OR, van Lanschot JJ, van Berge Henegouwen MI. Risk factors for development of benign cervical strictures after esophagectomy. Ann Surg. 2010;251(6):1064–9.

    Article  PubMed  Google Scholar 

  34. Nederlof N, Tilanus HW, Tran TC, Hop WC, Wijnhoven BP, de Jonge J. End-to-end versus end-to-side esophagogastrostomy after esophageal cancer resection: a prospective randomized study. Ann Surg. 2011.

    Google Scholar 

  35. Honkoop P, Siersema PD, Tilanus HW, Stassen LP, Hop WC, van Blankenstein M. Benign anastomotic strictures after transhiatal esophagectomy and cervical esophagogastrostomy: risk factors and management. J Thorac Cardiovasc Surg. 1996;111(6):1141–6.

    Article  PubMed  CAS  Google Scholar 

  36. van Hooft JE, van Berge Henegouwen MI, Rauws EA, Bergman JJ, Busch OR, Fockens P. Endoscopic treatment of benign anastomotic esophagogastric strictures with a biodegradable stent. Gastrointest Endosc. 2011;73(5):1043–7.

    Article  PubMed  Google Scholar 

  37. Pierie JP, de Graaf PW, Poen H, van der Tweel I, Obertop H. Incidence and management of benign anastomotic stricture after cervical oesophagogastrostomy. Br J Surg. 1993;80(4):471–4.

    Article  PubMed  CAS  Google Scholar 

  38. Biere SS, Cuesta MA, van der Peet DL. Minimally invasive versus open esophagectomy for cancer: a systematic review and meta-analysis. Minerva Chir. 2009;64:121–33.

    PubMed  CAS  Google Scholar 

  39. Nagpal K, Ahmed K, Vats A, et al. Is minimally invasive surgery beneficial in the management of esophageal cancer ? A meta-analysis. Surg Endosc. 2010;24:1621–9.

    Article  PubMed  Google Scholar 

  40. Sgourakis G, Gockel I, Radtke A, et al. Minimally invasive versus open esophagectomy: meta-analysis of outcomes. Dig Dis Sci. 2010;55:3031–40.

    Article  PubMed  Google Scholar 

  41. Biere SS, van Berge Henegouwen MI, Maas KW, et al. Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet. 2012;379:1887–92.

    Article  PubMed  Google Scholar 

  42. Locke III GR, Talley NJ, Fett SL, Zinsmeister AR, Melton III LJ. Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmsted County, Minnesota. Gastroenterology. 1997 May;112(5):1448–56.

    Article  PubMed  Google Scholar 

  43. van Lanschot JJ, Gouma DJ, Jansen PLM, Jones EA, Pinedo HM, Schouten WR, et al. Integrated medical and surgical gastroenterology. Houten: Bohn Stafleu Van Loghum; 2004.

    Google Scholar 

  44. Boeckxstaens GE, Annese V, des Varannes SB, Chaussade S, Costantini M, Cuttitta A, et al. Pneumatic dilation versus laparoscopic Heller's myotomy for idiopathic achalasia. N Engl J Med. 2011;364(19):1807–16.

    Article  PubMed  CAS  Google Scholar 

  45. Draaisma WA, Gooszen HG, Tournoij E, Broeders IA. Controversies in paraesophageal hernia repair: a review of literature. Surg Endosc. 2005;19(10):1300–8.

    Article  PubMed  CAS  Google Scholar 

  46. Iqbal A, Haider M, Desai K, Garg N, Kavan J, Mittal S, et al. Technique and follow-up of minimally invasive Heller myotomy for achalasia. Surg Endosc. 2006;20(3):394–401.

    Article  PubMed  CAS  Google Scholar 

  47. Erdogan A, Gurses G, Keskin H, Demircan A. The sealing effect of a fibrin tissue patch on the esophageal perforation area in primary repair. World J Surg. 2007;31(11):2199–203.

    Article  PubMed  Google Scholar 

  48. Trus TL, Bax T, Richardson WS, Branum GD, Mauren SJ, Swanstrom LL, et al. Complications of laparoscopic paraesophageal hernia repair. J Gastrointest Surg. 1997;1(3):221–7.

    Article  PubMed  CAS  Google Scholar 

  49. Haider M, Iqbal A, Salinas V, Karu A, Mittal SK, Filipi CJ. Surgical repair of recurrent hiatal hernia. Hernia. 2006;10(1):13–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Atrium Medical Center, Heerlen, The Netherlands

    Rachel L. G. M. Blom

  2. Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands

    Donald L. van der Peet MD

  3. Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands

    Mark I. van Berge Henegouwen MD, PhD

Authors
  1. Rachel L. G. M. Blom
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Donald L. van der Peet MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mark I. van Berge Henegouwen MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mark I. van Berge Henegouwen MD, PhD .

Editor information

Editors and Affiliations

  1. Department of Surgery, VU University Medical Centre, Amsterdam, The Netherlands

    Miguel A. Cuesta

  2. Department of Surgery, VU University Medical Centre, Amsterdam, The Netherlands

    H. Jaap Bonjer

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag London

About this chapter

Cite this chapter

Blom, R.L.G.M., van der Peet, D.L., van Berge Henegouwen, M.I. (2014). Prevention and Treatment of Major Complications After Esophageal Surgery. In: Cuesta, M., Bonjer, H. (eds) Treatment of Postoperative Complications After Digestive Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-4354-3_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-4354-3_8

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4353-6

  • Online ISBN: 978-1-4471-4354-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation