Repair using the pectoralis major muscle flap for anastomotic leakage after esophageal reconstruction via the subcutaneous route

Morita, Masaru; Ikeda, Keisuke; Shimada, Masahiko; Saeki, Hiroshi; Egashira, Akinori; Yoshinaga, Keiji; Oki, Eiji; Sadanaga, Noriaki; Kakeji, Yoshihiro; Fukushima, Junichi; Maehara, Yoshihiko

doi:10.1016/j.surg.2009.08.013

Cited by 27 publications

(28 citation statements)

References 25 publications

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“…Traditional therapy for a symptomatic postoperative esophageal fistula has been surgical repair or, if unsuccessful, esophageal diversion, which prolongs hospitalization and significantly delays oral hydration and nutrition. 19 It is worthy of consideration as a mechanism that the continuous compromise of nutrition caused by the anastomotic leakage may weaken immune function and make the host more susceptible to tumor recurrence in compromised patients.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Postoperative Complications After Curative Resection for Patients With Esophageal Squamous Cell Carcinoma

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Postoperative Complications After Curative Resection for Patients With Esophageal Squamous Cell Carcinoma

et al. 2017

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“…Leakage is curable by tissue recovery and granulation in most cases, and intractable esophagocutaneous fistula rarely develops. Intractable fistulas require more aggressive treatment, such as covered stents [19,20], primary closure and vascularized pedicle tissue flaps [7,21,22]. Covered stent insertion into the cervical esophagus often causes strong pharyngeal discomfort or stent migration.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, vascularized pedicle tissue flaps are used to repair perforations or fistulas around the cervical anastomosis. In previous reports, the pectoralis major muscle flap has been used comparatively more often for repair [7,22,23,24]. The pectoralis major muscle flap is a good method with which to prevent recurrent fistula formation because of its abundant muscle volume.…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of Sternocleidomastoid Flap Repair for Cervical Anastomotic Leakage after Esophageal Reconstruction

Nakajima

Satomura²,

Takahashi³

et al. 2014

Dig Surg

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Background/Aims: The purpose of this study was to investigate the effectiveness of sternocleidomastoid (SCM) flap repair for anastomotic leakage after esophagectomy. Methods: A refractory cutaneous fistula from the gastric stump developed in 8 patients with esophageal cancer who underwent esophagogastric anastomosis after esophagectomy. All patients underwent SCM flap repair. The cutaneous fistula was removed and resutured. The sternal head of the left SCM was dissected from the manubrium of the sternum and sutured onto the repaired gastric stump. Results: The operative duration was 80-220 min (median, 120 min). The amount of intraoperative bleeding ranged from 5 to 182 g (median, 15 g). The absence of recurrent anastomotic leakage was confirmed after the SCM flap repair in every patient. Oral intake was initiated 7-15 days (median, 10 days) after the repair operation without discomfort. Conclusions: SCM flap repair is an effective and minimally invasive treatment method for cervical anastomotic leakage after esophageal reconstruction. This method may be considered in patients with refractory leakage of the gastric stump after staple anastomosis. i 2014 S. Karger AG, Basel

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“…The pharyngeal-ileal anastomosis was covered with a pectoralis major muscle flap, since it was a relatively well-vascularized structure and had sufficient bulk to cover the anastomosis completely (Fig. 4c) [7,8].…”

Section: Case Reportmentioning

confidence: 99%

Staged resection and reconstruction following definitive chemoradiotherapy for perforated cervico-thoracic esophageal cancer with mediastinal abscess

et al. 2011

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Esophageal perforation with mediastinal abscess formation is a potentially life-threatening complication after chemoradiotherapy (CRT) in patients with esophageal cancer. We present the case of a 64-year-old woman with cervico-thoracic esophageal cancer who had previously undergone distal gastrectomy. Definitive CRT was initially performed since the patient refused laryngectomy. However, she developed an esophageal fistula and a subsequent cervico-mediastinal abscess, which made oral intake impossible. In order to address the fistula, abscess, and cancer, we decided to perform a staged operation. The patient first underwent total pharyngo-laryngo-esophagectomy and abscess drainage. She next underwent esophageal reconstruction with an ileocolonic conduit through a subcutaneous route. The patient is currently alive and well after surgery. This case suggests that surgical resection may be performed in high-risk patients with cervico-thoracic esophageal cancer via a two-stage operation.

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Repair using the pectoralis major muscle flap for anastomotic leakage after esophageal reconstruction via the subcutaneous route

Cited by 27 publications

References 25 publications

Prognostic Significance of Postoperative Complications After Curative Resection for Patients With Esophageal Squamous Cell Carcinoma

Prognostic Significance of Postoperative Complications After Curative Resection for Patients With Esophageal Squamous Cell Carcinoma

Effectiveness of Sternocleidomastoid Flap Repair for Cervical Anastomotic Leakage after Esophageal Reconstruction

Staged resection and reconstruction following definitive chemoradiotherapy for perforated cervico-thoracic esophageal cancer with mediastinal abscess

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