Right chest empyema secondary to esophagogastric anastomotic disruption following gastroesophagectomy for adenocarcinoma. Re-opened the right thoracotomy wound. Upon entering the right chest a large volume of pus was drained. There was a large amount of fibrinous debris and a peel which was ultimately removed from the lung. There was nearly complete disruption of the esophagogastric anastomosis. Repair was not feasible. The gastric segment was exculded using a stapler. A 2-0 Prolene pursestring suture was used to close off the esophageal segment. Prior to securing the suture a nasogastric tube was placed to drain the blind pouch. A second suture was used to reinforce the initial closure of the esophagus. Bioglue was used to close off some pleural tears which had allowed some air leaks. Chest tubes placed for drainage. The pt. was closed.
Apprecitate any help this is a new one for me.
Apprecitate any help this is a new one for me.