The ways to reduce fatal complication of intrapleural esophagoplasty for esophageal and gastroesophageal junction cancer

The authors have analyzed the treatment results in 159 esophageal or esophagogastric junction cancer patients who have undergone intrapleural esophagoplasty. The total morbidity after surgery makes up 45,28 % and mortality was 18,87 %. The statistical analysis shows that among all the complications only pneumonia after surgery (p=0,000), transplant necrosis (p=0,038) and also inconsistency of anastomosis sutures (p=0,025) contributed to the frequency in mortal cases. Failure of tracheobronchial drainage function on the background of postoperative ischemic bronchitis was a risk factor of postoperative pneumonia. Systemic arterial hypotension and hypofibrinogenemia affected transplant viability. Frequency of anastomotic leakages significantly depended on anastomosis construction. The reduction of fatal complication of intrapleural esophagoplasties was achieved by working up of new surgical technique of esophageal anastomosis and procedure of tracheal catheterization with permanent sputum aspiration.