Perm Medical JournalPerm Medical Journal0136-14492687-1408Eco-Vector568410.17816/pmj33423-27Research ArticleRISK FACTORS FOR ESOPHAGOGASTRIC ANASTOMOSIS FAILURE DEPENDING ON TYPE OF ESOPHAGEAL PLASTYPlaksinS Asplaksin@mail.ruSablinE E-15082016334232718112016Copyright © 2016, Plaksin S.A., Sablin E.E.2016Aim. The aim of the study was to improve the results of treatment of esophageal anastomosis failure in esophagoplasty. Materials and methods. During 20 years, 262 esophageal resections with different variants of plasty for cancer and benign esophageal diseases were fulfilled. Anastomosis failure was developing in 65 % of cases (24,8 %). Results. More frequently anastomosis failure was developing after the posteromediastinal esophagogastroplasty - in 43 patients (38,4 %). Following the proximal gastric resections with esophageal resection from laparotomy approach, complications were diagnosed 11 patients (24,3 %), gastrectomy with esophageal resection - in 6 persons (16,2 %). Anastomosis failure occurred after Lewis surgeries - in 5 cases (7,7 %). Twenty three (35,4 %) patients underwent the repeated surgeries. Thirty one patients died (11,4 %). Death caused by purulent complications following anastomosis failure was registered in 58,1 % of patients. Surgical circular stapling instruments CDH and CEEA used for the formation of anastomosis permitted to reduce its failure rate from 34,1 to 15,4 %, and experience of esophageal surgery - to decrease lethality from 19,1 to 6,8 % for 20 years. Conclusions. Esophageal anastomosis failure more often occurs after the posteromediastinal esophagogastroplasty, rarely - after Lewis surgery that is connected with peculiar features of transplant blood supply. Machine suture raises reliability of anastomosis.Esophagoplastyanastomosis failuresurgical stapling instrumentsrepeated surgeriescomplicationsЭзофагопластиканесостоятельность анастомозасшивающие аппаратыповторные операцииосложнения[Бурмистров М.В., Сигал Е.И., Бебезов С.И., Еникеев Р.Ф., Шарапов Т.Л., Сигал Р.Е., Федоров В.И., Хазиев Р.А. Совершенствование способов профилактики несостоятельности пищеводно-желудочного анастомоза. VI Международный конгресс «Актуальные направления современной кардиоторакальной хирургии» (9-11 июня 2016 г.): тезисы докладов. СПб. 2016; 198-199.][Сулиманов Р.А., Спасский Е.С., Сулиманов Р.Р., Бондаренко С.В. Меры предупреждения несостоятельности швов эзофагогастроанастомоза после операции Льюиса. VI Международный конгресс «Актуальные направления современной кардиоторакальной хирургии» (9-11 июня 2016 г.): тезисы докладов. СПб. 2016; 177-178.][Lerut T., Coosemans W., Decker G. Anastomotic complications after esophagectomy. Dig. Surg. 2002; 19 (2): 92-98.][Metzger R., Bollschweiler E., Vallbohmer D., Maish M., DeMeester T.R., Holscher A.H. High volume centers for esophagectomy: what is the number to achieve low postoperative mortality? Deseases of Esophagus 2004; 17: 310-314.][Oezcelik A., Banki F., Ayazi S., Abate E., Zehetner J., Sohn H.J., Hagen J.A., DeMeester S.R., Lipham J.C., Palmer S.L., DeMeester T.R. Detection of gastric conduit ischemia or anastomotic breakdown after cervical esophagogastrostomy: the use of computed tomography scan versus early endoscopy. Surg. Endosc. 2010; 24: 1948-1951.][Schaheen L., Blackmon S.H., Nason K.S. Optimal approach to the management of intrathoracic esophageal leak following esophagectomy: a systematic review. Am. J. Surg. 2014; 208 (4): 536-543.][Shen K.R., Harrison-Phipps, Cassivi S.D., Wigle D., Nichols F.C. Esophagectomy after anti-reflux surgery. Esophagectomy after anti-reflux surgery. J. Thorac. Cardiovask. Surg. 2010; 139: 969-975.][Shweigert M., Solvmosi N., Dubecz A., Stadlhuber R.J., Muschweck H., Ofner D., Stein H.J. Endoscopic stent insertion for anastomotic leakage following oesofagectomy. Ann. R. Coll. Surg. Engl. 2013; 95 (1): 43-47.][Zehetner J., DeMeester S.R., Alicuben E.T., Oh D.S., Lipham J.C., Hagen J.A., DeMeester T.R. Intraoperative assessment of perfusion of the gastric graft and correlation with anastomotic leaks after esophagectomy. Ann. Surg. 2015; 262 (1): 74-78.]