Retrosternal Esophagogastrostomy with the EEA Stapler after Subtotal Resection of the Esophagus: Application and Results

Imamura, Masayuki; Ohishi, K; Mizutani, Naomi; Yanagibashi, Ken; Naito, Mitsuru; Shimada, Yutaka; Hattori, Yasuaki; Satomura, Kazunari; Tobe, Takayoshi

doi:10.1159/000171780

Cited by 6 publications

(5 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A gastric tube with a width of 4 cm was usually fashioned. Anastomosis was done in the cervical region by hand sewing or circular stapler (25 mm EEA) [ 9 ]. When a free jejunal graft was used, we first made a hand sewn pharyngo-jejuno anastomosis and then performed microvascular anastomosis.…”

Section: Methodsmentioning

confidence: 99%

“…Among several causes of anastomotic leakage, ensuring an adequate blood supply is the most important point for performing anastomosis safely after esophagectomy. In 1986, we introduced the EEA stapler for esophago-gastrostomy after resection of part of the sternum following subtotal esophagectomy [ 9 ], and the average anastomotic leakage rates from 1994 to 2008 were 4.8% (20/416).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Usefulness of blood supply visualization by indocyanine green fluorescence for reconstruction during esophagectomy

et al. 2011

Self Cite

View full text Add to dashboard Cite

BackgroundAdequate blood supply for the reconstructed organ is important for safe esophagogastric anastomosis during esophagectomy. Recently, indocyanine green (ICG) has been used for visualization of the blood supply when anastomosis is performed in vascular surgery. To visualize the blood supply for reconstruction, we employed ICG fluorescence during esophagectomy.MethodsFrom August 2008, 40 patients received cervical or thoracic esophagectomy. They consisted of 33 patients having esophagectomy for thoracic esophageal cancer, 3 being treated for cervical esophageal cancer, and 4 with double cancer of the thoracic and cervical regions. Before and after pulling up the reconstructed organ, 2.5 mg of ICG was injected as a bolus. Then ICG fluorescence was detected by a camera and recorded.ResultsICG fluorescence was easily detected in all patients at 1 min after injection. The vascular network was well visualized in the gastric wall, colonic grafts, and free jejunal grafts. In five patients, we also performed anastomosis between the short gastric vein and the external cervical vein or superficial cervical vein. The intraoperative and postoperative course of all patients was uneventful apart from three anastomotic leakages.ConclusionsICG fluorescence can be employed to evaluate the blood supply to reconstructed organs and can be useful in selecting the patients who do not need additional vessel anastomosis. However, anastomotic leakage was not reduced, so the microcirculation detected by ICG fluorescence did not necessarily provide appropriate blood supply for a viable anastomosis.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Usefulness of blood supply visualization by indocyanine green fluorescence for reconstruction during esophagectomy

et al. 2011

Self Cite

View full text Add to dashboard Cite

show abstract

“…The operation techniques used were as previously described (Imamura et al, 1987 goat serum in PBS for 30 min at room temperature to block nonspecific antibody reaction. Sections were incubated overnight at 4°C with anti-human VEGF polyclonal antibody in PBS containing 1% bovine serum albumin.…”

Section: Materials and Methods Clinical Materialsmentioning

confidence: 99%

In oesophageal squamous cell carcinoma vascular endothelial growth factor is associated with p53 mutation, advanced stage and poor prognosis

Uchida

Shimada²,

Watanabe³

et al. 1998

Br J Cancer

102

View full text Add to dashboard Cite

In oesophageal squamous cell carcinoma vascular endothelial growth factor is associated with p53 mutation, advanced stage and poor prognosis S Uchida, Y Shimada, G Summary Vascular endothelial growth factor (VEGF) affects malignant tumours by promoting angiogenesis. The tumour-suppressor gene p53 has been thought to regulate VEGF. We investigated the effect of VEGF on oesophageal carcinoma and the connection between VEGF and p53. One hundred and nine resected oesophageal squamous cell carcinomas were examined. VEGF expression was analysed by immunohistochemical staining. Sixty-five tumours (59.6%, 65 out of 109) were classified as VEGF positive. A significant correlation was found between the VEGF expression and both the depth of invasion (P = 0.0001) and lymph node metastasis (P < 0.0001). With regard to p53, we compared the expression of VEGF with the mutation of p53, examined using polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP) and direct sequencing in tumour samples obtained from 36 patients who we have reported previously. The VEGF expression was significantly correlated to p53 mutation (P = 0.0291). To evaluate the angiogenesis, microvascular density (MVD) was counted, and endothelial cells were stained immunohistochemically using anti-CD34 monoclonal antibody against 29 cases with invasion limited to the submucosal layer. The average MVD had a tendency to correlate to VEGF expression (P = 0.1626). The prognoses of patients with VEGFpositive primary tumours were significantly worse than for those with VEGF-negative primary tumours (P = 0.0077). We have assumed that VEGF contributes to aggressive characteristics in oesophageal carcinomas and that VEGF expression might be affected by p53 status.

show abstract

“…The operative techniques were as previously described (Imamura et al, 1987). Some samples were not available to conduct immunohistochemical staining, therefore the number of the cases examined in MRP-1/CD9 and KAI1/CD82 was not identical.…”

Section: Clinical Materialsmentioning

confidence: 99%

Motility-related protein (MRP-1/CD9) and KAI1/CD82 expression inversely correlate with lymph node metastasis in oesophageal squamous cell carcinoma

et al. 1999

View full text Add to dashboard Cite

Metastasis of cancer cells is believed to be influenced by many factors which progress through several stages as cancer cells move from a primary lesion to metastatic sites. One of those factors, cell motility, plays an important role in the progression, especially after the extravasation. Motility-related protein 1 (MRP-1/CD9), which belongs to the transmembrane 4 superfamily of membrane proteins, is considered to inhibit cell motility (Miyake et al, 1991). It has been demonstrated that the cells which expressed MRP-1/CD9 by transfection showed suppressed cell motility in vitro (Ikeyama et al, 1993). An inverse correlation was found between MRP-1/CD9 expression and metastases in breast cancer , and reduced MRP-1/CD9 gene expressions resulted in poor prognoses in non-small cell lung cancer . KAI1/CD82 is also one of the transmembrane 4 superfamily of membrane proteins which has similar effects, mediating metastasis and correlating positively with good prognosis in patients with nonsmall cell lung cancer (Adachi et al, 1996) and inversely with metastasis in prostatic cancers (Dong et al, 1995;Dong, 1996). There were no studies of MRP-1/CD9 and KAI1/CD82 in oesophageal cancer. In this paper, we investigated expressions of MRP-1/CD9 and KAI1/CD82 in oesophageal cancer. MATERIALS AND METHODS Clinical materialsTissues, whose expressions of MRP-1/CD9 and KAI1/CD82 were examined, were obtained from oesophageal cancer specimens of 108 and 104 patients, respectively, who underwent oesophagectomy at our institution, from June 1987 to December 1995. The operative techniques were as previously described (Imamura et al, 1987). Some samples were not available to conduct immunohistochemical staining, therefore the number of the cases examined in MRP-1/CD9 and KAI1/CD82 was not identical. All resected tumours were microscopically examined to identify histologic type, extent and mode of cancer invasion, and metastasis to lymph nodes. In some cases lymphatic invasion could be seen in the apparent absence of lymph node metastases. Considering this, we investigated the correlation between the expression of MRP-1/CD9 and lymphatic invasion in 98 out of 108 patients. Nine patients were excluded because lymphatic invasion could not be conclusively determined.Histologically, all of the patients had squamous cell carcinoma. No adenosquamous carcinoma or small cell variants were found. Tumour staging was based on the pTNM pathological classification system (Hermanek et al, 1987). The 5-year survival rates of all patients who received curative resections were examined.Specimens were fixed in a 10% formaldehyde solution and embedded in paraffin. Four-micrometre sections were cut and mounted on glass slides. Summary Although the mechanisms of action of the transmembrane superfamilies, motility-related protein-1 (MRP-1/CD9) and KAI1/CD82, are not well known, they are reported to suppress the metastasis of several kinds of cancers. The suppression of cell motility by MRP-1/CD9 may cause suppression of the metastasis. As we could not find any ...

show abstract

Retrosternal Esophagogastrostomy with the EEA Stapler after Subtotal Resection of the Esophagus: Application and Results

Cited by 6 publications

References 4 publications

Usefulness of blood supply visualization by indocyanine green fluorescence for reconstruction during esophagectomy

Usefulness of blood supply visualization by indocyanine green fluorescence for reconstruction during esophagectomy

In oesophageal squamous cell carcinoma vascular endothelial growth factor is associated with p53 mutation, advanced stage and poor prognosis

Motility-related protein (MRP-1/CD9) and KAI1/CD82 expression inversely correlate with lymph node metastasis in oesophageal squamous cell carcinoma

Contact Info

Product

Resources

About