The authors report five cases of emergency reoperation for breakdown of an intrathoracic oeso-digestive anastomosis.
Results: 1 death, 1 failure, new fistula formation but with spontaneous cure within 20 days, 3 primary cures. The success of these reoperations seems to us to depend narrowly: - on the rapidity of diagnosis, facilitated at present by early radiological examination; - on the absolute emergency of reoperation as soon as the breakdown is obvious radiologically and clinically, - on the strictness of surgical technic which should be the same as for a cold operation. Early radiological examination of the digestive anastomoses has permitted better understanding of the mechanisms of the breakdown, emphasising: - firstly, the importance of complete hemostasis; - secondly, the suppression of any dead space around the anastomosis.