Role of Gastrografin Study in the Assessment of Anastomotic Leaks From Cervical Oesophagogastric Anastomosis

Goel, Arun; Sinha, Siddhartha; Tk, Chattopadhyay

doi:10.1111/j.1445-2197.1995.tb01738.x

Cited by 16 publications

(16 citation statements)

References 11 publications

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“…Three false or pseudo-leaks were suggested on contrast swallow, as has been described previously [24,32,33]. Well-performed contrast studies and detailed knowledge of the type of surgical anastomosis used is imperative if contrast swallow examinations are to be correctly interpreted.…”

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that this is of poor sensitivity and specificity, failing to identify clinically significant anastomotic leaks or demonstrating pseudo-leaks (contrast cascade due to endto-side anastomosis rather than leak) [10,21]. As a result, some suggest that the routine use of contrast swallow be discontinued [22][23][24][25]. Lamb et al in a study of 66 patients showed routine contrast swallow to have a sensitivity of 66.6% and concluded that there is no role for routine contrast swallow after total gastrectomy.…”

mentioning

confidence: 99%

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Prospective trial comparing contrast swallow, computed tomography and endoscopy to identify anastomotic leak following oesophagogastric surgery

et al. 2007

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Prospective trial comparing contrast swallow, computed tomography and endoscopy to identify anastomotic leak following oesophagogastric surgery

et al. 2007

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“…219 All patients underwent a contrast (Gastrografin) study on the day 5 postoperatively, followed by 'test feeding' with drinking water in the surgical ward. The drain site dressings were removed and the drain site…”

Section: Gollub and Bainsmentioning

confidence: 99%

“…Evans et al, Surgery: pancreatic surgery Definition: as below 1997, 248 UK (n = 63) Clinical features: not described Aim: a largely prospective study to analyse the medium-term outcome Investigations: the presence of a pancreatic fistula was defined by the of surgery for chronic pancreatitis, production of > 50 ml/day abdominal fluid with an amylase content of with particular emphasis on the > 1000 unit/l (normal value < 300 unit/l) quality of life for patients based on the mortality and morbidity rates associated with surgery, relief of symptoms, analgesic use, employment and long-term sequelae of pancreatic surgery 293 and orthotopic bladder substitution Germany via the ileal neobladder Clinical features: not described, but the authors do refer to insufficiency of the ileal anastomosis Aim: to report on the morbidity and complications of a series of 306 men Investigations: a variety of examinations were conducted over the who received an ileal neobladder and follow-up period (3-month intervals in years 1 and 2, 6-month intervals in in whom complete follow-up was years 3 and 4, annually thereafter 219 India Aim: a prospective study comparing Clinical features: leak at neck site Gastrografin study with test feeding (done in the surgical ward using Investigations: routine imaging, regardless of clinical signs. All patients drinking water) in a series of underwent Gastrografin study on day 5 postoperatively, followed by 'test 25 consecutive patients with cervical feeding' with drinking water (more description is given on p. 68) oesophagogastric anastomosis.The issues to be answered were: (1) are any anastomotic leaks missed by using 'test feeding' instead of Gastrografin study; and (2) Investigations: soluble contrast enema was used to confirm clinical altered haemostatic balance in the suspicion.…”

Section: Medline and Healthstarmentioning

confidence: 99%

The measurement and monitoring of surgical adverse events

Bruce

Russell

Mollison

et al. 2001

Health Technol Assess

296

209

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK.We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTAThe measurement and monitoring of surgical adverse events NHS R&D HTA ProgrammeT he NHS R&D Health Technology Assessment (HTA) Programme was set up in 1993 to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS.Initially, six HTA panels (pharmaceuticals, acute sector, primary and community care, diagnostics and imaging, population screening, methodology) helped to set the research priorities for the HTA Programme. However, during the past few years there have been a number of changes in and around NHS R&D, such as the establishment of the National Institute for Clinical Excellence (NICE) and the creation of three new research programmes: Service Delivery and Organisation (SDO); New and Emerging Applications of Technology (NEAT); and the Methodology Programme.Although the National Coordinating Centre for Health Technology Assessment (NCCHTA) commissions research on behalf of the Methodology Programme, it is the Methodology Group that now considers and advises the Methodology Programme Director on the best research projects to pursue.The research reported in this monograph was funded as project number 97/16/04.The views expressed in this publication are those of the authors and not necessarily those of the Methodology Programme, HTA Programme or the Department of Health. The editors wish to emphasise that funding and publication of this research by the NHS should not be taken as implicit supp...

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“…apparent leaks represented only a proportion of the total who had radiological anastomotic leaks [3,[10][11][12][13] .…”

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confidence: 99%

Effectiveness of Screening Aqueous Contrast Swallow in Detecting Clinically Significant Anastomotic Leaks after Esophagectomy

et al. 2005

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Background: Aqueous contrast swallow study is recommended as a screening procedure for the evaluation of esophageal anastomotic integrity following esophagectomy. The aim of this study was to assess the accuracy of water-soluble contrast swallow screening as a predictor of clinically significant anastomotic leak in patients with esophagectomy. Patients and Methods: The records of 505 consecutive patients undergoing esophagectomy in Mayo Clinic from January 1991 through December 1995 were retrospectively reviewed. 464 (92%) pa tients had water-soluble contrast swallows performed in the early postoperative period (median postoperative day 7, range 4–11 days). Results: A total of 39 radiological leaks were obtained but only 17 of these had clinical signs of anastomotic leakage. Furthermore, 25 patients who had normal swallow study developed a clinical anastomotic leak. There were therefore 22 (4.7%) false positive and 25 (5.4%) false negative results giving values for the specificity, sensitivity and false negative error rate of the radiological examination of 94.7, 40.4, and 59.5% respectively. Aspiration of the contrast agent was noted on fluoroscopy in 30 (6.5%) patients. Only 2 (0.4%) patients developed aqueous contrast agent-caused aspiration pneumonia. There was no procedure-related mortality. Conclusion: While radiological assessment of esophageal anastomoses in the early postoperative period using aqueous contrast agents appears to be a relatively safe procedure, the poor sensitivity and high false negative error rate of this technique, when performed on postoperative day 7 and in a series with clinical anastomotic leak rate of 9%, is insufficient for it to be worthwhile as a screening procedure.

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Role of Gastrografin Study in the Assessment of Anastomotic Leaks From Cervical Oesophagogastric Anastomosis

Cited by 16 publications

References 11 publications

Prospective trial comparing contrast swallow, computed tomography and endoscopy to identify anastomotic leak following oesophagogastric surgery

Prospective trial comparing contrast swallow, computed tomography and endoscopy to identify anastomotic leak following oesophagogastric surgery

The measurement and monitoring of surgical adverse events

Effectiveness of Screening Aqueous Contrast Swallow in Detecting Clinically Significant Anastomotic Leaks after Esophagectomy

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