Superdrainage of the ileocolic vein to the internal jugular vein interposed by an inferior mesenteric vein graft in replacing the esophagus with the right hemicolon

Uchiyama, Hideaki; Morita, Masaru; Toh, Yasushi; Saeki, Hiroshi; Kakeji, Yoshihiro; Matsuura, Hiroshi; Maehara, Yoshihiko

doi:10.1007/s00595-009-4081-y

Cited by 10 publications

(11 citation statements)

References 13 publications

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“…We believe that these procedures are time‐consuming and invasive in contrast with harvesting a graft. For example, the IMV graft may be harvested from the mesocolon in under 10 minutes 25 . Although an additional anastomosis is required for this procedure, adequate blood drainage is accomplished by directly anastomosing a drainage vein to the internal jugular vein.…”

Section: Discussionmentioning

confidence: 99%

“…Veins were anastomosed in an end‐to‐side manner when the internal jugular vein was selected as an outflow vein. The vein graft was interposed between the veins when the distance between the veins was too long 25 . For instance, an inferior mesenteric vein (IMV) graft, approximately 10 cm in length, was harvested from the mesocolon and immersed in heparinized saline.…”

Section: Methodsmentioning

confidence: 99%

“…The vein graft was interposed between the veins when the distance between the veins was too long. 25 For instance, an inferior mesenteric vein (IMV) graft, approximately 10 cm in length, was harvested from the mesocolon and immersed in heparinized saline. The proximal end of the IMV graft was anastomosed to a cervical vein, and the distal end was anastomosed to a vein of the conduit.…”

Section: Microvascular Anastomosismentioning

confidence: 99%

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Esophageal replacement by colon interposition with microvascular surgery for patients with thoracic esophageal cancer: the utility of superdrainage

Saeki

Morita

Harada

et al. 2012

Diseases of the Esophagus

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Replacing the thoracic esophagus with the colon is one mode of reconstruction after esophagectomy for esophageal cancer. There is, however, a high incidence of postoperative necrosis of the transposed colon. This study evaluated the outcomes of colon interposition with the routine use of superdrainage by microvascular surgery. Twenty-one patients underwent colon interposition from 2004 to 2009. The strategy for colon interposition was to: (i) use the right hemicolon; (ii) reconstruct via the subcutaneous route; (iii) perform a microvascular venous anastomosis for all patients; and (iv) perform a microvascular arterial anastomosis when the arterial blood flow was insufficient. The clinicopathologic features, surgical findings, and outcomes were investigated. The colon was used because of a previous gastrectomy in 18 patients (85.7%) and synchronous gastric cancer in three patients (14.3%). Eight patients (38.1%) underwent preoperative chemoradiotherapy including three (14.3%) treated with definitive chemoradiotherapy. Seven patients (33.3%) underwent microvascular arterial anastomosis to supplement the right colon blood supply. Pneumonia occurred in four patients (19.0%). Anastomotic leakage was observed in five patients (23.8%); however, no colon necrosis was observed. The 3-year and 5-year overall survival rates were both 50.6%. Colon interposition with superdrainage results in successful treatment outcomes. This technique is one option for colon interposition employing the right hemicolon.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Microvascular Anastomosismentioning

confidence: 99%

See 1 more Smart Citation

Esophageal replacement by colon interposition with microvascular surgery for patients with thoracic esophageal cancer: the utility of superdrainage

Saeki

Morita

Harada

et al. 2012

Diseases of the Esophagus

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“…Some surgeons have reported the utility of both supercharge and superdrainage in cases of colon interposition after esophagectomy [18]. Shirakawa et al [19] reported that the supercharge technique for colonic interposition was advantageous with regards to peri-operative complications and contributes to the patient's quality of life.…”

Section: Discussionmentioning

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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“…Other candidate drainage veins are the anterior cervical vein, the external jugular vein, and so forth. Because a direct anastomosis of the ileocolic vein to the internal jugular vein cannot be accomplished in most cases, we have recently used an inferior mesenteric vein graft interposition to fill the gap between the two vessels [32].…”

Section: Supercharge and Superdrainage Of A Right Hemicolon Conduit Fmentioning

confidence: 99%

Expanding the applications of microvascular surgical techniques to digestive surgeries: a technical review

et al. 2011

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In living donor liver transplantation (LDLT), it is considered safer to reconstruct hepatic arteries (HAs) under a microscope than under conventional loupe magnification, because graft HA stumps are generally thin and short with an average diameter of approximately 2 mm. We first applied microvascular surgical techniques to HA reconstruction for LDLT in 1996. In most cases, we use a disposable double-clip to secure the graft and recipient arteries, and interrupted 8-0 nonabsorbable monofilament sutures. We next started performing resection and reconstruction of the right HA in a surgery for hilar cholangioma using the same technique as in LDLT. Lately, we have started applying microvascular surgical techniques to various digestive surgeries; namely, supercharge and superdrainage in esophageal surgery, vascular reconstruction in free jejunal interposition grafts for cervical esophageal cancer, resection and reconstruction of spontaneous HA aneurysms, jejunal artery reconstruction for spontaneous superior mesenteric artery dissections, and so forth. Mastering this technique is time consuming. However, once a surgeon masters the technique it has almost unlimited applications, and most vital vessels can be safely reconstructed using this method. We herein provide a technical review of the application of microvascular surgical techniques for various digestive surgeries.

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Superdrainage of the ileocolic vein to the internal jugular vein interposed by an inferior mesenteric vein graft in replacing the esophagus with the right hemicolon

Cited by 10 publications

References 13 publications

Esophageal replacement by colon interposition with microvascular surgery for patients with thoracic esophageal cancer: the utility of superdrainage

Esophageal replacement by colon interposition with microvascular surgery for patients with thoracic esophageal cancer: the utility of superdrainage

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

Expanding the applications of microvascular surgical techniques to digestive surgeries: a technical review

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