Role of Barium Swallow in Diagnosing Clinically Significant Anastomotic Leak following Esophagectomy
Author
Roh, Simon; Iannettoni, Mark D.; Keech, John C.; Bashir, Mohammad; Gruber, Peter J.; Parekh, Kalpaj R.
Abstract
Background
Barium swallow is performed following esophagectomy to evaluate the anastomosis for detection of leaks and to assess the emptying of the gastric conduit. The aim of this study was to evaluate the reliability of the barium swallow study in diagnosing anastomotic leaks following esophagectomy.
Methods
Patients who underwent esophagectomy from January 2000 to December 2013 at our institution were investigated. Barium swallow was routinely done between days 5–7 to detect a leak. These results were compared to clinically determined leaks (defined by neck wound infection requiring jejunal feeds and or parenteral nutrition) during the postoperative period. The sensitivity and specificity of barium swallow in diagnosing clinically significant anastomotic leaks was determined.
Results
A total of 395 esophagectomies were performed (mean age, 62.2 years). The indications for the esophagectomy were as follows: malignancy (n=320), high-grade dysplasia (n=14), perforation (n=27), benign stricture (n=7), achalasia (n=16), and other (n=11). A variety of techniques were used including transhiatal (n=351), McKeown (n=35), and Ivor Lewis (n=9) esophagectomies. Operative mortality was 2.8% (n=11). Three hundred and sixty-eight patients (93%) underwent barium swallow study after esophagectomy. Clinically significant anastomotic leak was identified in 36 patients (9.8%). Barium swallow was able to detect only 13/36 clinically significant leaks. The sensitivity of the swallow in diagnosing a leak was 36% and specificity was 97%. The positive and negative predictive values of barium swallow study in detecting leaks were 59% and 93%, respectively.
Conclusion
Barium swallow is an insensitive but specific test for detecting leaks at the cervical anastomotic site after esophagectomy.
Subject
Date
2016-04
Citation:
APA:
Roh, Simon, & Iannettoni, Mark D., & Keech, John C., & Bashir, Mohammad, & Gruber, Peter J., & Parekh, Kalpaj R.. (April 2016).
Role of Barium Swallow in Diagnosing Clinically Significant Anastomotic Leak following Esophagectomy.
The Korean Journal of Thoracic and Cardiovascular Surgery,
49(2),
99-
106. Retrieved from
http://hdl.handle.net/10342/5415
MLA:
Roh, Simon, and Iannettoni, Mark D., and Keech, John C., and Bashir, Mohammad, and Gruber, Peter J., and Parekh, Kalpaj R..
"Role of Barium Swallow in Diagnosing Clinically Significant Anastomotic Leak following Esophagectomy". The Korean Journal of Thoracic and Cardiovascular Surgery.
49:2. (99-106),
April 2016.
November 30, 2023.
http://hdl.handle.net/10342/5415.
Chicago:
Roh, Simon and Iannettoni, Mark D. and Keech, John C. and Bashir, Mohammad and Gruber, Peter J. and Parekh, Kalpaj R.,
"Role of Barium Swallow in Diagnosing Clinically Significant Anastomotic Leak following Esophagectomy," The Korean Journal of Thoracic and Cardiovascular Surgery 49, no.
2 (April 2016),
http://hdl.handle.net/10342/5415 (accessed
November 30, 2023).
AMA:
Roh, Simon, Iannettoni, Mark D., Keech, John C., Bashir, Mohammad, Gruber, Peter J., Parekh, Kalpaj R..
Role of Barium Swallow in Diagnosing Clinically Significant Anastomotic Leak following Esophagectomy. The Korean Journal of Thoracic and Cardiovascular Surgery.
April 2016;
49(2):
99-106.
http://hdl.handle.net/10342/5415. Accessed
November 30, 2023.
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