Intraluminal continuous decompression and drainage using a vacuum pump for controlling cervical anastomotic leakage after a three-field esophagectomy with a gastric pull-up

Shichinohe, Toshiaki; Ebihara, Yuma; Murakami, Soichi; Kurashima, Yo; Fukuda, Naoya; Poudel, Saseem; Miyazaki, Dai; Tsuchikawa, Takahiro; Hirano, Satoshi

doi:10.1007/s10388-015-0505-5

Cited by 1 publication

(2 citation statements)

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“…Esophageal cancer is the sixth leading cause of cancer-related mortality worldwide and is ranked fourth in China [ 1 , 2 ]. Surgical treatment is the primary choice for nonmetastatic esophageal cancer according to international guidelines [ 3 , 4 ]. Minimally invasive surgical approaches, which result in smaller sutures, fewer postoperative complications and faster recovery than more open surgical approaches, have been widely accepted by both patients and surgeons.…”

Section: Introductionmentioning

confidence: 99%

“…Minimally invasive surgical approaches, which result in smaller sutures, fewer postoperative complications and faster recovery than more open surgical approaches, have been widely accepted by both patients and surgeons. Minimally invasive McKeown esophagectomy (MIE McKeown), i.e., thoraco-laparoscope-assisted esophagectomy with left cervical anastomosis, is a mainstream surgical technique for esophageal malignancies that can achieve a wider oncological resection margin and better lymph node harvest than intrathoracic anastomoses or transhiatal esophagectomy [ 4 , 5 ]. However, the main disadvantage of MIE McKeown is anastomotic fistulae, which can prolong hospitalization and increase the occurrence of anastomoses and anastomotic stenosis [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Covering the gastric tube with the mediastinal pleura during minimally invasive McKeown esophagectomy can reduce the incidence of anastomotic fistulae.

Zhu

Liu

et al. 2021

Videosurgery and Other Miniinvasive Techniques

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Introduction The rate of anastomotic leakage from intrathoracic esophagogastric anastomoses can be reduced by covering them with the mediastinal pleura. Whether anastomotic leakage can be reduced by covering the portion of the gastric tube in the upper mediastinum with the mediastinal pleura during minimally invasive McKeown esophagectomy (MIE McKeown) is unknown. Aim To evaluate the consequence of covering the mediastinal pleural during minimally invasive McKeown esophagectomy. Material and methods Consecutive patients who underwent MIE McKeown between January 2015 and December 2019 were retrospectively analyzed. Participants for whom the portion of the gastric tube in the upper mediastinum was not covered with the mediastinal pleura were assigned to group A; otherwise, they were assigned to group B. Chi-square analysis and univariable and multivariable logistic analyses were used to compare the differences between the two groups and explore the risk factors for anastomotic fistulae. Results A total of 267 patients with middle and lower esophageal cancer were included in this study (131 in group A and 136 in group B). Anastomotic leakage occurred in 5 patients (5/136) in group B compared with 13 patients (13/131) in group A (p = 0.042). Univariable and multivariable logistic analyses identified a gastric tube not covered with the mediastinal pleura as a risk factor for significantly greater anastomotic leakage (p = 0.042), but it was not an independent prognostic factor for anastomotic leakage (odds ratio = 0.585, 95% confidence interval: lower bound: 0.069, upper bound, 1.122). Conclusions This study provides preliminary evidence that covering the gastric tube with the mediastinal pleura during MIE McKeown can decrease the incidence of anastomotic leakage.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Covering the gastric tube with the mediastinal pleura during minimally invasive McKeown esophagectomy can reduce the incidence of anastomotic fistulae.

Zhu

Liu

et al. 2021

Videosurgery and Other Miniinvasive Techniques

View full text Add to dashboard Cite

show abstract

Intraluminal continuous decompression and drainage using a vacuum pump for controlling cervical anastomotic leakage after a three-field esophagectomy with a gastric pull-up

Abstract: Background: Anastomotic leakage is one of the major complications that can occur

Cited by 1 publication

References 9 publications

Covering the gastric tube with the mediastinal pleura during minimally invasive McKeown esophagectomy can reduce the incidence of anastomotic fistulae.

Covering the gastric tube with the mediastinal pleura during minimally invasive McKeown esophagectomy can reduce the incidence of anastomotic fistulae.

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