A retrospective study of anastomotic leakage between patients with and without vascular enhancement of esophageal reconstructions with colon interposition: Thammasat University Hospital experience

Background: Anastomotic leakage is a common complication after operative reconstruction with colon interposition in corrosive esophageal injury patients. Because the underlying causes are ischemic in nature, vascular enhancement would resolve this complication. Objective: To compare the incidence of anastomotic leakage between patients with and without vascular enhancement of esophageal reconstructions with colon interposition. Materials and methods: This is a retrospective comparative study between patients with and without vascular enhancement during corrosive esophageal reconstructions with colon interposition in Thammasat University Hospital from January 2004 to December 2012. Results: Twenty-five adult patients who received esophageal reconstructions with colon interposition for corrosive esophageal injury were included in this study. Eleven of these patients also received vascular enhancement (classified as the “with vascular enhancement” group) during the reconstruction, whereas the remaining 14 patients did not (classified as the “without vascular enhancement” group). There was no significant difference in baseline characteristics of the patients between the two groups (i.e., sex, age, and preoperative hematocrit and serum albumin levels). There was also no significant difference in the leakage rate between the two groups: 35.7% (5/14) and 9% (1/11) in the without and with vascular enhancement groups, respectively (p = 0.180). However, in the “with vascular enhancement” group, the operative time was significantly longer (7.8 hours vs. 6.4 hours; an additional 1.4 hours), whereas length of hospital stay was shorter (18.3 days vs. 28.1 days; reduced by 9.8 days) compared with the other group. Conclusions: Patients who received vascular enhancement along with colon interposition had a lower incidence of anastomotic leakage; however, there was no significant difference between the two groups in this study. Thus, further studies with a large sample size should be conducted in this regard