Abstract
Objectives Aspirations are common after esophagectomy. Data are lacking regarding its long-term
radiological manifestations. The purpose of this study is to determine the incidence
and radiological patterns of aspirations among long-term survivors and evaluate their
clinical significance.
Methods The records of all patients who underwent esophagectomy between October 2003 and
December 2011 and survived more than 3 years were reviewed. Preoperative, first routine
postoperative, and latest chest computed tomography (CT)scans were reviewed. Imaging
studies were reviewed for radiological signs suspicious of aspirations, conduit location,
anastomotic site, and maximal intrathoracic diameter. Data regarding patients' complaints
during clinic visits were also collected.
Results A total of 578 patients underwent esophagectomy during the study period. One-hundred
twenty patients met the inclusion criteria. Median follow-up was 83.5 months. Cervical
and intrathoracic anastomoses were performed in 103 and 17 patients, respectively.
A higher rate of CT findings was found in postoperative imaging (n = 51 [42.5%] vs. n = 13 [10.8%] respectively, p < 0.05). Most of these were found in the lower lobes (61%). A higher rate of lesions
was found among patients in whom the conduit was bulging to the right hemithorax compared
with totally mediastinal or completely in the right hemithorax (54.5 vs. 35.2% and
34.6%, respectively, p < 0.05). No correlation was found with conduit diameter or anastomotic site. These
lesions were more prevalent among patients who complained of reflux or cough during
meals (NS).
Conclusions A significantly higher rate of new CT findings was found in postoperative imaging
of this post-esophagectomy cohort, suggesting a high incidence of aspirations. The
locations of the conduit, rather than anastomosis site, seem to play a role in the
development of these findings. Further research is needed to evaluate the clinical
significance of these findings.
Keywords
esophagectomy - aspiration - imaging
