Safety of EEA staplers for anastomosis between upper esophagus and the gastric tube

Sugimachi, Keizō; Ohno, Shinji; Maekawa, Soichiro; Mori, Masaki; Kuwano, Hiroyuki; Ueo, Hiroaki

doi:10.1002/jso.2930430111

Cited by 12 publications

(9 citation statements)

References 15 publications

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“…This procedure is an adaptation of intrathoracic reconstruction using a narrow gastric tube after thoracic esophagectomy for esophageal cancer 9 . The procedure has several advantages: 5 (i) it is technically simple and the operation time is short; (ii) food tolerance is good and delayed emptying or reflux esophagitis is rare; and (iii) the procedure does not sacrifice the proximal part of the jejunum, which is important for the digestion and absorption of nutrients.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic evaluation of reconstruction after proximal gastrectomy for cancer: Gastric tube versus jejunal interposition

Kakisako

Tamura

Katsuta

et al. 2001

Digestive Endoscopy

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Background: Since 1997, we have introduced proximal gastrectomy and gastric tube reconstruction for patients with small or superficial cancer of the gastric cardia. The aim of the present study was to present our experience with proximal gastrectomy in these patients and to assess the usefulness of this technique. Methods: We studied 12 patients who underwent proximal gastrectomy for cancer of the gastric cardia at the Koga Hospital. The mode of anastomosis was gastric tube reconstruction (n = 8) or jejunal interposition (n = 4). Clinical and endoscopic findings were evaluated with special reference to the reflux esophagitis. Results: Operation time for gastric tube reconstruction was significantly shorter than that for jejunal interposition (234 vs 359 min, respectively; P < 0.01). Although one patient with jejunal interposition experienced dysphagia and vomiting, no patient with gastric tube reconstruction had such symptoms. Endoscopy showed that one symptomatic patient with jejunal interposition and one asymptomatic patient with gastric tube reconstruction had esophagitis. The remaining patients were free from esophagitis on endoscopy and all patients were alive without recurrence. Conclusion: In patients with proximal gastrectomy, surgical and endoscopic results were satisfactory after gastric tube reconstruction. Because the procedure is simple and safe, this technique is the treatment of choice for early proximal gastric cancer.

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Section: Discussionmentioning

confidence: 99%

Endoscopic evaluation of reconstruction after proximal gastrectomy for cancer: Gastric tube versus jejunal interposition

Kakisako

Tamura

Katsuta

et al. 2001

Digestive Endoscopy

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show abstract

“…Our technique is an application of intrathoracic reconstruction in which a gastric tube was used after thoracic esophagectomy for esophageal cancer [18]. De spite negative pressure in the thoracic cavity, gastric tube reconstruction after esophagocardiectomy for cancer of the gastric cardia or abdominal esophagus does not result in reflux esophagitis.…”

Section: Discussionmentioning

confidence: 99%

Surgical results of proximal gastrectomy for early-stage gastric cancer: jejunal interposition and gastric tube reconstruction

et al. 1999

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Abstract:Background. The frequency of tumors in the upper one-third of the stomach has been increasing. The standard operation for proximal gastric cancer has been total or proximal gastrectomy. The aim of this study was to present the pathologic and surgical results of 30 patients with early-stage proximal gastric cancer managed by proximal gastrectomy. Methods. A consecutive series of 30 patients who underwent proximal gastrectomy for early-stage proximal gastric cancer was studied. Sixteen patients underwent jejunal interposition, while 14 underwent gastric tube reconstruction, which consisted of a direct anastomosis between the esophagus and the remnant of the tube-like stomach. Results. Twenty patients (67%) had no abdominal symptoms and the lesions were detected by screening gastric fiberscopy. The tumors were mostly located along the lesser curvature (73%), were grossly depressed type (IIc) (70%), and histologically well differentiated type (63%). The depth of wall invasion was the mucosa in 12 patients, submucosa in 15, and muscularis propria in 3; lymph node metastasis was absent in 28 patients (93%). When compared with patients with jejunal interposition, patients with gastric tube reconstruction had a shorter operation time (327 vs 165 min), less blood loss (508 vs 151 g), and shorter hospital stay after operation (31 vs 17 days). Endoscopy and 24-h pH monitoring showed no evidence of reflux esophagitis, except in 1 patient with gastric tube reconstruction, and no patient died of recurrence. Conclusions. Early-stage proximal gastric cancer can be successfully treated by proximal gastrectomy. Since gastric tube reconstruction is a simple, easy, and safe procedure, proximal gastrectomy followed by gastric tube reconstruction is recommended for patients with early-stage proximal gastric cancer. Offprint requests to: Y. Adachi

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“…It was reported that recent advances of the EEA sta pling device reduced the incidence of anastomotic leakage [18,19]. It is considered that the intrathoracic anastomo sis using the EEA stapling device is a safe procedure.…”

Section: Discussionmentioning

confidence: 99%

Thoracic Esophagectomy for Lower Esophageal Cancer through Left Oblique Thoracolaparotomy and Right Posterolateral Thoracotomy

et al. 1995

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Radical operations for lower esophageal cancer, including lymph node dissection in the upper, middle and lower mediastinal and the upper abdominal regions were performed through a left oblique thoracolaparotomy and a right posterolateral thoracotomy in 5 cases. A satisfactory surgical view through the oblique thoracolaparotomy insured easy, safe and complete removal of the tumor and the lymph nodes in the lower mediastinal and upper abdominal regions, and additional right posterolateral thoracotomy was useful for the lymph node dissection in the upper and middle mediastinum. Reconstruction was performed by the intrathoracic anastomosis between the upper esophagus and the gastric tube or jejunum using the EEA stapling device. Extubation of a tracheal tube was possible within 3 days after operation in all cases, and no respiratory complication was noted in any case. This new approach for lower esophageal cancer is considered to be useful for easy, safe and complete removal of the tumor and the regional lymph nodes.

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Safety of EEA staplers for anastomosis between upper esophagus and the gastric tube

Cited by 12 publications

References 15 publications

Endoscopic evaluation of reconstruction after proximal gastrectomy for cancer: Gastric tube versus jejunal interposition

Endoscopic evaluation of reconstruction after proximal gastrectomy for cancer: Gastric tube versus jejunal interposition

Surgical results of proximal gastrectomy for early-stage gastric cancer: jejunal interposition and gastric tube reconstruction

Thoracic Esophagectomy for Lower Esophageal Cancer through Left Oblique Thoracolaparotomy and Right Posterolateral Thoracotomy

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