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Prospective trial comparing contrast swallow, computed tomography and endoscopy to identify anastomotic leak following oesophagogastric surgery

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An Erratum to this article was published on 20 August 2008

Abstract

Background

Anastomotic leaks are a major complication of oesophagogastric surgery. We compare contrast swallow fluoroscopy, computed tomography (CT) with oral contrast and endoscopy in identifying anastomotic leaks following oesophagogastric surgery.

Methods

A prospective trial of 38 patients undergoing oesophagogastric resection was undertaken with informed consent and institutional review board (ethics committee) approval. Patients underwent all three investigations (over 24 hours) 1 week postoperatively.

Results

Eight (21%) had clinically apparent leaks. Three pseudo-leaks were suggested on contrast swallow but were confirmed normal on CT and endoscopy. Contrast swallow and CT missed one anastomotic leak each. Endoscopy identified anastomotic defects in three patients, in whom CT and contrast swallow were either normal or conflicting.

Conclusions

Routine tests of anastomotic integrity are unnecessary. When clinically suspected, contrast swallow or CT with oral contrast will identify most leaks. Endoscopy is useful in cases where there are incongruous results.

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Author information

Author notes

  1. Brian A. Hogan

    Present address: , 31, 1535 Trossacks Avenue, N5F 4R1, London, Ontario, Canada

Authors and Affiliations

  1. Department of Radiology, R.C.S.I. Educational & Research Centre, Beaumont Hospital, Dublin 9, Ireland

    Brian A. Hogan & Michael J. Lee

  2. Department of Surgery, Beaumont Hospital, Dublin, Ireland

    Desmond Winter, David Broe & Patrick Broe

Authors
  1. Brian A. Hogan
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  2. Desmond Winter
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  3. David Broe
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  4. Patrick Broe
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Correspondence to Brian A. Hogan.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00464-008-0094-7

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Hogan, B.A., Winter, D., Broe, D. et al. Prospective trial comparing contrast swallow, computed tomography and endoscopy to identify anastomotic leak following oesophagogastric surgery. Surg Endosc 22, 767–771 (2008). https://doi.org/10.1007/s00464-007-9629-6

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  • DOI: https://doi.org/10.1007/s00464-007-9629-6

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