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Esophageal Leaks Repaired by a Muscle Onlay Approach in the Presence of Mediastinal Sepsis  Nikos Kotzampassakis, MD, Michel Christodoulou, MD, Thorsten.

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Presentation on theme: "Esophageal Leaks Repaired by a Muscle Onlay Approach in the Presence of Mediastinal Sepsis  Nikos Kotzampassakis, MD, Michel Christodoulou, MD, Thorsten."— Presentation transcript:

1 Esophageal Leaks Repaired by a Muscle Onlay Approach in the Presence of Mediastinal Sepsis 
Nikos Kotzampassakis, MD, Michel Christodoulou, MD, Thorsten Krueger, MD, Nicolas Demartines, MD, Henri Vuillemier, MD, Cai Cheng, MD, Gian Dorta, MD, Hans-Beat Ris, MD  The Annals of Thoracic Surgery  Volume 88, Issue 3, Pages (September 2009) DOI: /j.athoracsur Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Patient 15: (A) persistent esophageal leak at the level of the esophagogastric junction after multiple antireflux procedures and attempts to close the leak by surgery and stents; (B) endoscopic view of the diaphragmatic muscle flap (DF) sutured into the debrided esophageal defect; (C) contrast esophagography at day 8 revealing a patent esophagogastric junction without leakage; and (D) control endoscopy at 5 months revealing a well-integrated and epithelialized muscle patch without stenosis. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Schematic illustration of (A), closure of a middle third esophageal perforation by use of a latissimus dorsi muscle flap onlay repair; (B) closure of a fulminant intrathoracic anastomotic leak after esophagectomy by a muscle flap onlay approach using an intrathoracially transposed serratus anterior muscle flap; and (C) closure of a supradiaphragmatic esophageal leak by a diaphragmatic muscle onlay approach. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Patient 15: histologic assessment of biopsies harvested during control endoscopy 6 months after esophageal repair revealing malphigian reepithelialization of the muscle patch (hematoxylin and eosin stain; original magnification × 20). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

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