Cornerstone of the treatment of esophageal cancer is surgery in which the esophagus is removed and the stomach is used to create a gastric tube. About 50-75% of patients develop complications after this major operation. The most feared is an anastomotic leakage, in which leakage occurs between the connection of the esophagus and the gastric tube. This thesis shows that endoscopic treatment is successful in the majority of patients with a limited leakage, as a result these patients do not need to undergo major reoperation. An example is suction drainage, in which a nasogastric tube is placed through the nose into the cavity of the defect, to allow the leakage to heal. This appears to be an effective treatment, which can be completed at home. An international survey and focus groups show that there is still a lot of variation in the treatment of anastomotic leakage worldwide. Therefore, it was not possible to make a treatment algorithm for anastomotic leakages at the end of this thesis, more research will have to follow.
Merel Lubbers (1990) obtained her medical degree in 2014 and then started working as surgical resident at Hospital Group Twente (ZGT), Almelo and Hengelo. In 2016, she started her PhD research into the treatment of complications after esophagectomy. In 2018 she started with the surgical training and hereafter she collaborated with prof. dr. C. Rosman of the Radboud University Medical Centre to complete her dissertation.