Intra-operative hypotensive episodes may be associated with post-operative esophageal anastomotic leak

Uberto Fumagalli, Alessandra Melis, Jana Balazova, Valeria Lascari, Emanuela Morenghi, Riccardo Rosati

Research output: Contribution to journalArticlepeer-review


This study aims to report the hypotensive episodes (HEs) during esophagectomy and their influence on the occurrence of anastomotic leak. Eighty-four patients underwent esophagectomy with gastric pull-up. Pre-, intra-, and post-operative data were prospectively collected. HEs were defined by systolic pressure decreasing more than 30 % of the basal value for more than 5 min. Nineteen patients had intra-operative HEs (22.6 %). HEs were significantly more frequent in patients undergoing prone esophagectomy (P = 0.001) and those with an epidural catheter (EC) (P = 0.04) used during surgery. Among them, 15 were treated with vasopressors. There were six severe post-operative anastomotic leaks, which required surgery; leaks were significantly more common in patients with intra-operative HEs (21 vs 3.1 %; P = 0.02), especially those treated with vasopressive agents (20 vs 0 %; P = 0.008). Intra-operative use of EC can, in certain conditions, significantly influence gastric blood flow due to HEs. A higher incidence of severe leak occurred in patients experiencing intra-operative HEs. Several factors can lead to intra-operative HEs, and the perioperative use of an EC should be carefully evaluated.

Original languageEnglish
Pages (from-to)185-190
Number of pages6
JournalUpdates in Surgery
Issue number2
Publication statusPublished - Jun 1 2016


  • Anastomotic healing
  • Anastomotic leak
  • Esophagectomy
  • Hypothension
  • Intra-operative fluid management
  • Thoracic epidural analgesia

ASJC Scopus subject areas

  • Surgery


Dive into the research topics of 'Intra-operative hypotensive episodes may be associated with post-operative esophageal anastomotic leak'. Together they form a unique fingerprint.

Cite this