A reliable operative procedure for preparing a sufficiently nourished gastric tube for esophageal reconstruction

Ueo, Hiroaki; Abe, Ryoji; Takeuchi, Hideya; Arinaga, Shinya; Akiyoshi, Tsuyoshi

doi:10.1016/s0002-9610(05)80525-2

Cited by 14 publications

(14 citation statements)

References 4 publications

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“…Sectioning of these arteries is usually necessary to mobilize the stomach up to the cervical region, in patients who undergo esophagectomy with esophagogastric reconstruction. However, a great number of authors believe that sectioning of these arteries leads to gastric fundus ischemia and consequent dehiscence of the esophagogastric anastomosis [2,[5][6][7][8]. Other authors believe that sectioning the gastric arteries does not cause any harm to stomach irrigation because of the rich anastomotic network of mucous and submucous layers [12].…”

Section: Discussionmentioning

confidence: 99%

“…It is the leading cause of deaths occurring as a result of surgical treatment of esophageal carcinoma [1,2,[5][6][7][8][9]]. An anastomotic leak rate of up to 37% is described in the literature, and 9.5% of the deaths due to this operation are related to such leaks [9].…”

Section: Introductionmentioning

confidence: 99%

“…It is believed that anastomotic dehiscence is mainly due to ischemia of the gastric fundus [1,5,10,11]. Nonetheless, tension in the anastomotic suture, lack of esophageal serous layer, infection, and inadequate surgical technique have also been described as factors leading to this complication [1].…”

Section: Introductionmentioning

confidence: 99%

“…Other authors believe that sectioning the short gastric, left gastric, and gastro-omental arteries section, which is an essential procedure in subtotal transhiatal esophagectomy with esophagogastric reconstruction, causes ischemia in the gastric fundus [2,[5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Vascular Flow of the Gastric Fundus After Arterial Devascularization: An Experimental Study

Gomes¹,

Ramacciotti²,

Miranda

et al. 2009

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Vascular Flow of the Gastric Fundus After Arterial Devascularization: An Experimental Study

Gomes¹,

Ramacciotti²,

Miranda

et al. 2009

Journal of Surgical Research

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“…Diante da alta incidência da fístula esofagogástrica e da importante morbi-mortalidade por ela acarretada, várias manobras técnicas foram descritas para diminuir sua freqüência: proteção da anastomose com cola de fibrina 21 , anastomose em dois tempos 22 , rotação do fundo gástrico 23 , revascularização microcirúrgica da víscera transposta 24 , anastomose mecânica 15 , confecção laparoscópica do tubo gástrico cinco dias antes da esofagectomia 18 , preservação da arcada vascular do hilo esplênico 25 , administração de prostaglandina E1 26 e anastomose com invaginação [27][28][29] .…”

Section: Introdução Introdução Introdução Introdução Introduçãounclassified

Estudo comparativo entre as anastomoses cervicais esofagogástrica término-terminal com e sem invaginação após esofagectomia para câncer

Henriques

Zanon

Godinho

et al. 2009

Rev. Col. Bras. Cir.

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Subtotal stomach in esophageal reconstruction surgery achieves an anastomotic leakage rate of less than 1%

Yoshida

Tanaka

Imai

et al. 2020

Annals of Gastroent Surgery

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Aim The objective of this retrospective, single‐institution study was to assess the safety and feasibility of reconstruction using subtotal stomach (SS) with esophagectomy for patients with esophageal cancer (EC). Although several different gastric‐tube‐making and anastomotic methods have been reported, the incidence rate of anastomotic leakage with EC surgery is generally reported over 10%. Complications should be avoided, and patient quality of life (QOL) should be maintained postoperatively. We have used SS reconstruction and hand‐sutured cervical esophagus‐subtotal gastric anastomosis at the neck wound in EC surgery. Short‐ and long‐term outcomes in cases using SS are not well known. Methods Between January 2008 and September 2019, 300 patients underwent esophagectomy for EC and reconstruction using SS. The primary endpoint was the rate of anastomotic leakage. Secondary endpoints were postoperative morbidities, QOL, and changes in patients’ body weight and skeletal muscle weight. Results Anastomotic leakage was observed in two patients (0.67%), and pneumonia was observed in nine patients (3.0%). Fifteen patients (5.0%) had an anastomotic stenosis requiring a bougie. Nausea occurred in 11 patients (3.7%), and dumping syndrome occurred in seven patients (2.3%). Dysphagia and early feeling of abdominal fullness scores tended to be high after surgery but gradually decreased after 6 months. Good results were obtained for reflux feeling scores. Body weight changed with an average decrease of −2 ± 3.71 kg ( P = .071) over 5 years. Conclusion Reconstruction using SS resulted in an extremely low rate of anastomotic leakage and good QOL postoperatively in patients with EC.

show abstract

A reliable operative procedure for preparing a sufficiently nourished gastric tube for esophageal reconstruction

Cited by 14 publications

References 4 publications

Vascular Flow of the Gastric Fundus After Arterial Devascularization: An Experimental Study

Vascular Flow of the Gastric Fundus After Arterial Devascularization: An Experimental Study

Estudo comparativo entre as anastomoses cervicais esofagogástrica término-terminal com e sem invaginação após esofagectomia para câncer

Subtotal stomach in esophageal reconstruction surgery achieves an anastomotic leakage rate of less than 1%

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