Colonic interposition and supercharge for esophageal reconstruction

Shirakawa, Yasuhiro; Naomoto, Yoshio; Noma, Kazuhiro; Sakurama, Kazufumi; Nishikawa, Toshio; Nobuhisa, Tetsuji; Kobayashi, Masahiko; Okawa, Takaomi; Asami, Shinya; Yamatsuji, Tomoki; Haisa, Minoru; Matsuoka, Junji; Hanazaki, Motohiko; Morita, Kiyoshi; Hiraki, Takao; Tanaka, Noriaki

doi:10.1007/s00423-005-0010-8

Cited by 43 publications

(50 citation statements)

References 18 publications

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“…Factors associated with higher cancer recurrence risks include tumor differentiation, advanced stage, lymph node invasion and involvement of surgical margins. Treatment of local recurrence is extremely complex, with greater difficulty in the posterior mediastinal transposition [26][27][28] . The recurrence recorded in the patients described here was restricted to stages III and IV, attesting to the greater relevance of tumor aggressiveness.…”

Section: Discussion Discussion Discussion Discussion Discussionmentioning

confidence: 99%

Total esophagogastrectomy in the neoplasms of the esophagus and esofagogastric junction: when must be indicated?

Andreollo

Neto

Calomeni

et al. 2015

Rev. Col. Bras. Cir.

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Objective: to analyse the indications and results of the total esophagogastrectomy in cancers of the distal esophagus and esophagogastric junction. Methods: twenty patients with adenocarcinomas were operated with a mean age of 55 ± 9.9 years (31-70 years), and 14 cases were male (60%). Indications were 18 tumors of the distal esophagus and esophagogastric junction (90%) and two with invasion of gastric fundus (10%) in patients with previous gastrectomy. Preoperative colonoscopy to exclude colonic diseases was performed in ten cases. Results: the surgical technique consisted of median laparotomy and left cervicotomy, followed by transhiatal esophagectomy associated with D2 lymphadenectomy. The reconstructions were performed with eight esophagocoloduodenoplasty and the others were Roux-en-Y esophagocolojejunoplasty to prevent the alkaline reflux. Three cases were stage I / II, while 15 cases (85%) were stages III / IV, reflecting late diagnosis of these tumors. The operative mortality was 5 patients (25%): a mediastinitis secondary to necrosis of the transposed colon, abdominal cellulitis secondary to wound infection, severe pneumonia, an irreversible shock and sepsis associated with colojejunal fistula. Four patients died in the first year after surgery: 3 (15%) were due to tumor recurrence and 1 (5%) secondary to bronchopneumonia. The 5-year survival was 15%. Conclusion: the total esophagogastrectomy associated with esophagocoloplasty has high morbidity and mortality, requiring precise indication, and properly selected patients benefit from the surgery, with the risk-benefit acceptable, contributing to increased survival and improved quality of life

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Section: Discussion Discussion Discussion Discussion Discussionmentioning

confidence: 99%

Total esophagogastrectomy in the neoplasms of the esophagus and esofagogastric junction: when must be indicated?

Andreollo

Neto

Calomeni

et al. 2015

Rev. Col. Bras. Cir.

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“…the operation lasted only 30 min more. They preferred the branches of the internal carotid artery (superior thyroid, lingual, facial, ascending pharyngeal) for supercharge and the jugular vein for venous anastomosis [42].…”

Section: Direct Revascularisation Of the Colonic Graft For Oesophageamentioning

confidence: 99%

Hypervascularisation of colonic graft for oesophageal replacement: literature review and own experience

Varabei¹,

Vizhynis²,

Makhmudov³

et al. 2017

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Colonic interposition in post-burn oesophageal strictures still remains a challenge. The main issue is the viability of the cervical portion of the colonic graft. The article provides a literature review on mesentericography and hypervascularisation of colonic graft for oesophageal replacement. The authors share their own experience. The study of the colic arterial anatomy enables one to choose its more perfused portion for oesophageal replacement. In insufficient blood supply, direct anastomoses with cervical or internal thoracic vessels have been proposed for hypervascularisation of the cervical part of graft. The technique of vessel ligation with a subsequent intensive collateral blood flow has been designed for hypervascularisation of the colonic graft. StreszczenieWstawka z okrężnicy w zwężeniach przełyku po oparzeniach nadal stanowi wyzwanie. Głównym problemem jest żywot-ność szyjnej części przeszczepu okrężnicy. W artykule przedstawiono przegląd piśmiennictwa dotyczącego mezenterikografii i hiperwaskularyzacji przeszczepu okrężnicy w celu odtworzenia przełyku. Autorzy przedstawiają także doświadczenia własne. Badanie anatomii tętnic okrężniczych pozwala na ich wybór do unaczynienia części okrężnicy zastępującej przełyk. W przypadku niedostatecznego dopływu krwi zaproponowano bezpośrednie zespolenie z naczyniami szyjnymi lub naczyniami piersiowymi wewnętrznymi w celu hiperwaskularyzacji szyjnej części wszczepu. Technika podwiązania naczyń z następczą intensyfikacją krążenia obocznego może być zastosowana również do poprawy unaczynienia części okrężnicy mającej zastąpić przełyk.

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“…Las complicaciones posteriores a la interposición de colon pueden ser agudas o crónicas, con frecuencia devastadoras [17][18][19] . Se necesitan estrategias creativas para solucionar esas complicaciones [16][17][18][19][20] . En un estudio de de Delva y cols.…”

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“…Algunos autores sugieren el empleo de anastomosis vasculares micro-quirúgicas para aumentar el aporte sanguíneo al segmento ascendido con el objetivo de disminuir la isquemia, necrosis y fístulas postoperatorias [17][18][19] ; no tenemos experiencia con esta técnica. Autores japoneses han reportado disminución de la incidencia de fístula y 0% de pérdida del segmento colónico ascendido con una baja mortalidad operatoria 17,20,21 .…”

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Reconstitución De Tránsito Esofágico Con Interposición De Colon Derecho

et al. 2015

Rev Chil Cir

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esophageal reconstruction using right colon interposition background: Esophageal replacement therapy is indicated for benign and malignant esophageal lesions and can be performed using stomach, jejunum or colon. aim: To report the experience using right colon interposition for esophageal replacement. material and methods: Review of medical records of 41 patients aged 17 to 73 years (29 males), subjected to right colon interposition in the last 20 years. Indications, complications, mortality and long term results were recorded. results: Forty nine percent of patients had a malignant esophageal lesion. Esophagectomy was performed using a transhiatal route or thoracotomy in 44 and 30% of patients, respectively. Retroesternal ascension was the most common route used in 88% of patients. The most common surgical complication was cervical fistula in 29% of patients, followed by fistula of the anastomosis between colon and jejunum in 7% of patients. Pneumonia was the most common medical complication. Postoperative mortality was 7%. conclusions: The mortality in this series of patients is similar to that reported elsewhere.

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Colonic interposition and supercharge for esophageal reconstruction

Abstract: For reconstruction of the esophagus, the colonic interposition and supercharge technique is advantageous and contributes to the patient's quality of life.

Cited by 43 publications

References 18 publications

Total esophagogastrectomy in the neoplasms of the esophagus and esofagogastric junction: when must be indicated?

Total esophagogastrectomy in the neoplasms of the esophagus and esofagogastric junction: when must be indicated?

Hypervascularisation of colonic graft for oesophageal replacement: literature review and own experience

Reconstitución De Tránsito Esofágico Con Interposición De Colon Derecho

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