Esophageal anastomosis - how the granulation phase of wound healing improves the incidence of anastomotic leakage

Taboła, Renata; Augoff, Katarzyna; Lewandowski, Andrzej; Ziółkowski, Piotr; Szelachowski, Piotr; Grabowski, Krzysztof

doi:10.3892/ol.2016.4873

Cited by 7 publications

(3 citation statements)

References 38 publications

(83 reference statements)

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“…Many efforts have been undertaken to develop new techniques that would prevent esophagogastric anastomotic leak [13,[29][30][31]. One feasible attempt might be the intentional delay of the postoperative oral intake in order to preserve the newly created anastomosis.…”

Section: Discussionmentioning

confidence: 99%

A nomogram illustrating the probability of anastomotic leakage following cervical esophagogastrostomy

et al. 2020

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Background Early diagnosis of anastomotic dehiscence following cervical esophagogastrostomy may become difficult. Estimation of an individual probability could help to establish preventive and diagnostic measures. The predictive impact of epidemiological, surgery-related data and laboratory parameters on the development of anastomotic dehiscence was investigated in the immediate perioperative period. Methods Retrospective study in 412 patients with cervical esophagogastrostomy following esophagectomy. Epidemiological data, risk factors, underlying disease, pre-treatment- and surgery-related data, C-reactive protein and albumin levels pre-and post-operatively were evaluated. We applied univariable and multivariable logistic regression analysis and developed a nomogram for individual risk assessment. Results There were 345 male, 67 female patients, mean aged 61.5 years; 284 had orthotopic, 128 retrosternal gastric pull-up; 331 patients had carcinoma, 81 non-malignant disease. Mean duration of operation was 184 min; 235 patients had manual, 113 mechanical and 64 semi-mechanical suturing; 76 patients (18.5%) developed anastomotic dehiscence clinically evident at mean 11.4 days after surgery. In univariable testing young age, retrosternal conduit transposition, manual suturing, high body mass index, high ASA and high postoperative levels of C-reactive protein were predictors for anastomotic leakage. These six parameters which had yielded a p < 0.1 in the univariable analysis, were entered into a multivariable analysis and a nomogram allowing the determination of the patient’s individual risk was created. Conclusion By using the nomogram as a supportive measure in the perioperative management, the patient’s individual probability of developing an anastomotic leak could be quantified which may help to take preventive measures improving the outcome.

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Section: Discussionmentioning

confidence: 99%

A nomogram illustrating the probability of anastomotic leakage following cervical esophagogastrostomy

et al. 2020

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“…However, after resection of the proximal gastric body, the anti-reflux mechanism is lost, and digestive juices of the patient can easily migrate upward when the patient is lying flat (38). Digestive juices are highly acidic, and the newly formed granular tissue at the esophagogastric anastomosis is more vulnerable to corrosion (39). The damaged site will cause an inflammatory response, which will lead to tissue deposition on the anastomotic site and eventually narrow the anastomotic site.…”

Section: Discussionmentioning

confidence: 99%

A new technology for reducing anastomotic fistula in the neck after esophageal cancer surgery

Song

Zhang

et al. 2019

J. Thorac. Dis

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“…The cellular and molecular mechanisms underlying oesophageal wound healing have recently attracted attention. Despite comparisons with gastric healing, the similarities to the epidermis have also prompted studies to disclose possible critical players in oesophageal response to wounding ( Baatar et al, 2002a , b ; Chai et al, 2007 ; Tarnawski and Ahluwalia, 2012 ; Jönsson et al, 2016 ; Tabola et al, 2016 ; Cai et al, 2018 ; Komaki et al, 2019 ; Boudaka et al, 2020 ).…”

Section: Wound Repair Mechanisms In Skin Oesophagus and Oral Epitheliamentioning

confidence: 99%

A Scarless Healing Tale: Comparing Homeostasis and Wound Healing of Oral Mucosa With Skin and Oesophagus

Pereira

Sequeira

2021

Front. Cell Dev. Biol.

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Epithelial tissues are the most rapidly dividing tissues in the body, holding a natural ability for renewal and regeneration. This ability is crucial for survival as epithelia are essential to provide the ultimate barrier against the external environment, protecting the underlying tissues. Tissue stem and progenitor cells are responsible for self-renewal and repair during homeostasis and following injury. Upon wounding, epithelial tissues undergo different phases of haemostasis, inflammation, proliferation and remodelling, often resulting in fibrosis and scarring. In this review, we explore the phenotypic differences between the skin, the oesophagus and the oral mucosa. We discuss the plasticity of these epithelial stem cells and contribution of different fibroblast subpopulations for tissue regeneration and wound healing. While these epithelial tissues share global mechanisms of stem cell behaviour for tissue renewal and regeneration, the oral mucosa is known for its outstanding healing potential with minimal scarring. We aim to provide an updated review of recent studies that combined cell therapy with bioengineering exporting the unique scarless properties of the oral mucosa to improve skin and oesophageal wound healing and to reduce fibrotic tissue formation. These advances open new avenues toward the ultimate goal of achieving scarless wound healing.

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Esophageal anastomosis - how the granulation phase of wound healing improves the incidence of anastomotic leakage

Abstract: Abstract.A two-stage esophagectomy with an interval for reconstruction of the esophagus creates an opportunity for the esophageal stump to recover from vessel injury and allows the formation of granulation tissue rich in

Cited by 7 publications

References 38 publications

A nomogram illustrating the probability of anastomotic leakage following cervical esophagogastrostomy

A nomogram illustrating the probability of anastomotic leakage following cervical esophagogastrostomy

A new technology for reducing anastomotic fistula in the neck after esophageal cancer surgery

A Scarless Healing Tale: Comparing Homeostasis and Wound Healing of Oral Mucosa With Skin and Oesophagus

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