Comparison of the subtotal and narrow gastric conduit for cervical esophagogastrostomy after esophagectomy in esophageal cancer patients: a propensity score-matched analysis

Sasaki, Ken; Tsuruda, Yusuke; Shimonosono, Masataka; Noda, Masahiro; Uchikado, Yasuto; Omoto, Itaru; Setoyama, Tetsuro; Matsushita, Daisuke; Arigami, Takaaki; Baba, Kenji; Kurahara, Hiroshi; Ohtsuka, Takao

doi:10.1007/s10388-023-01027-7

Esophagus

2023

DOI: 10.1007/s10388-023-01027-7

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Comparison of the subtotal and narrow gastric conduit for cervical esophagogastrostomy after esophagectomy in esophageal cancer patients: a propensity score-matched analysis

Ken Sasaki,

Yusuke Tsuruda,

Masataka Shimonosono

et al.

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2024

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Gastric conduit reconstruction after esophagectomy

Watanabe,

Takahashi,

Tamura

et al. 2024

Diseases of the Esophagus

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Summary A high risk of complications still accompanies gastric conduit reconstruction after esophagectomy. In this narrative review, we summarize the technological progress and the problems of gastric conduit reconstruction after esophagectomy. Several types of gastric conduits exist, including the whole stomach and the narrow gastric tube. The clinical outcomes are similar between the two types of conduits. Sufficient blood supply to the conduit is mandatory for a successful esophageal reconstruction. Recently, due to the availability of equipment and its convenience, indocyanine green angiography has been rapidly spreading. When the blood perfusion of the planning anastomotic site is insufficient, several techniques, such as the Kocher maneuver, pedunculated gastric tube with duodenal transection, and additional microvascular anastomosis, exist to decrease the risk of anastomotic failure. There are two different anastomotic sites, cervical and thoracic, and mainly two reconstructive routes, retrosternal and posterior mediastinal routes. Meta-analyses showed no significant difference in outcomes between the anastomotic sites as well as the reconstructive routes. Anastomotic techniques include hand-sewn, circular, and linear stapling. Anastomoses using linear stapling is advantageous in decreasing anastomosis-related complications. Arteriosclerosis and poorly controlled diabetes are the risk factors for anastomotic leakage, while a narrow upper mediastinal space and a damaged stomach predict leakage. Although standardization among the institutional team members is essential to decrease anastomotic complications, surgeons should learn several technical options for predictable or unpredictable intraoperative situations.

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Gastric conduit reconstruction after esophagectomy

Watanabe,

Takahashi,

Tamura

et al. 2024

Diseases of the Esophagus

View full text Add to dashboard Cite

show abstract

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Comparison of the subtotal and narrow gastric conduit for cervical esophagogastrostomy after esophagectomy in esophageal cancer patients: a propensity score-matched analysis

Cited by 1 publication

References 27 publications

Gastric conduit reconstruction after esophagectomy

Gastric conduit reconstruction after esophagectomy

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