Predictive Value of Early Postoperative Esophagoscopy for Occurrence of Benign Stenosis After Cervical Esophagogastrostomy

Trentino, P; Pompeo, Eugenio; Nofroni, Italo; Francioni, Federico; Rapacchietta, S.; Silvestri, Fred; Carboni, M; Mineo, Tommaso Claudio

doi:10.1055/s-2007-1004318

Cited by 28 publications

(21 citation statements)

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“…Early postoperative esophagoscopy and dilatation have been reported by Trentino et al [27]and Orringer et al [28]. We do agree that dilatation of a leaking anastomosis may favorably influence healing because relative narrowing by local inflammation and spasm may contribute to obstruction distal to an esophageal leak and adversely affect spontaneous closure.…”

Section: Management Of Anastomotic Leakssupporting

confidence: 68%

“…between days 3 and 5 and dilatation when necessary, seems to result in a decreased need for multiple dilatation. Trentino et al [27]reported a 83% success rate after a mean of 3.6 dilatations when performing early endoscopy and dilatation. The presence of ulceration involving more than 50% of the anastomotic circumference is the most important factor in predicting development of anastomotic stricture [27].…”

Section: Stenosismentioning

confidence: 99%

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Anastomotic Complications after Esophagectomy

Lerut¹,

Coosemans²,

Decker³

et al. 2002

Dig Surg

172

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Anastomotic complications after esophagectomy continue to be a burden jeopardizing the quality of life and of swallowing. However, incidence, mortality and morbidity of anastomotic complications have substantially decreased in recent years. It seems that this is not so much related to the use of a particular conduit, approach or route for reconstruction, but rather related to refinement in anastomotic techniques and perhaps even more to progress in modern perioperative management. Knowledge of surgical anatomy and meticulous technique are of paramount importance and obviously related to individual expertise. As to the management, most leaks can be treated by conservative measures and reintervention surgery today is rather exceptional. Early endoscopy and dilatation seem to decrease the incidence and severity of anastomotic stenosis.

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Section: Management Of Anastomotic Leakssupporting

confidence: 68%

Section: Stenosismentioning

confidence: 99%

Anastomotic Complications after Esophagectomy

Lerut¹,

Coosemans²,

Decker³

et al. 2002

Dig Surg

172

View full text Add to dashboard Cite

show abstract

“…Benigne Anastomosenstenosen nach Ösophagusresektion werden in der Literatur mit einer Häufigkeit von 9-56% angegeben [33,39,64,85].Anastomosenstenosen nach kolorektalen Resektionen werden mit einer Häufigkeit von 2-22% beschrieben [86,90]. Frühzeitig diagnostiziert kann durch eine effiziente endoskopische Therapie die Anastomosenstenose beseitigt und eine Reoperation vermieden werden.…”

Section: Sekundärkomplikationen Anastomosenstenosenunclassified

Chirurgische Nachuntersuchung und Endoskopie Das Problem der Sekundärkomplikation und des Lokalrezidivs

Wehrmann¹,

Saeger²

2002

Chirurg

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Minimal access techniques in surgery are improving. At the same time, the significance of interventional flexible endoscopy is increasing. Postoperative complications can be treated endoscopically with low rates of morbidity and mortality. Anastomotic strictures after resection of the esophagus, colon or rectum are mostly treated with success by endoscopy. Reoperations are almost never necessary in these cases today. Although the efficient detection of locoregional recurrence of gastrointestinal carcinoma is still the subject of controversial discussion, in contrast, endoscopic therapy for palliation by ablation, dilatation or stenting leads to a clear benefit for many of these patients.

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“…Although patients with early stage EC can benefit from surgery, complications drastically impair their quality of life and lead to increase in surgery-related mortality rates [5,6,7]. Dysphagia caused by anastomotic-stenosis is one of the major post-surgical complications occurring in 6.8-42% of patients after resection of esophageal cancer [8,9,10,11,12,13,14,15]. Thus, it is critical to define what is optimal treatment for this dreaded complication.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Combined Argon Plasma Coagulation and Savary Bougienage for the Relief of Anastomotic-Stenosis after Esophageal Squamous Cancer Surgery

Jia

Guo²,

Lv³

et al. 2014

Dig Surg

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Background: Several endoscopic dilation techniques have been reported for treatment of anastomotic-stenosis of esophageal cancer, but the high incidence of dysphagia has remained unchanged. The aim of this study was to compare the effect of Argon Plasma Coagulation (APC) combined with Savary Bougienage (SB) compared to APC alone or SB alone for anastomotic-stenosis after radical operation for squamous cell carcinoma of the esophagus. Methods: Patients with anastomotic-stenosis that was diagnosed for the first time following esophageal squamous cell carcinoma resection surgery were randomly assigned to undergo APC combined with SB, APC alone, or SB alone. Primary endpoints were the dysphagia-free survival (DFS defined as the time from first dilatation of effectively relieved dysphagia to dysphagia relapse expressed in days) after 6 months of follow up. Results: A total of 90 patients from the Cancer Institute, First Affiliated Hospital of Henan University of Science and Technology were entered into the study (APC group, n = 30, SB group, n = 30, combination group [APC combined with SB], n = 30). Primary endpoints: 6 months after treatment, DFS of combination group (115.63 days; 95% CI, 105.31-125.95) was significantly longer than the APC alone group (39.53 days; 95% CI, 35.95-43.11, p = 0.000) and the SB alone group (16.93 days; 95% CI, 15.01-18.84, p = 0.000). No severe complications occurred within the three treatment groups. Conclusions: APC combined with SB was a safe and well-tolerated method for relieving dysphagia of esophageal squamous cell cancer patients with anastomotic-stenosis. (Registered with randomized controlled trials, ChiCRT, registration number ChiCTR-TRC-13003757.)

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Predictive Value of Early Postoperative Esophagoscopy for Occurrence of Benign Stenosis After Cervical Esophagogastrostomy

Abstract: Early postoperative esophagoscopy seems a safe and effective tool for the monitoring of the anastomosis healing after cervical esophagogastrostomy. The presence of extended mucosal ulcerations appeared as the most important factor in predicting BAS formation.

Cited by 28 publications

References 0 publications

Anastomotic Complications after Esophagectomy

Anastomotic Complications after Esophagectomy

Chirurgische Nachuntersuchung und Endoskopie Das Problem der Sekundärkomplikation und des Lokalrezidivs

Evaluation of Combined Argon Plasma Coagulation and Savary Bougienage for the Relief of Anastomotic-Stenosis after Esophageal Squamous Cancer Surgery

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