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Esophageal anastomosis

Felipe Donoso, Helene Engstrand Lilja
Background Since 2005, infants with esophageal atresia (EA) in our unit are given prophylactic proton pump inhibitors (PPI) after repair until 1 year of age. The aims of this study were to identify risk factors for anastomotic strictures (AS) and to assess the efficacy of postoperative PPI prophylaxis in reducing the incidence of AS compared with symptomatic PPI. Methods Patients who underwent EA repair from 1994 to 2013 in our unit were included in this retrospective observational study approved by the local ethics review board...
October 21, 2016: European Journal of Pediatric Surgery
Keisuke Kubota, Akihiro Suzuki, Aoi Fujikawa, Takayuki Watanabe, Yuki Sekido, Hironori Shiozaki, Takashi Taketa, Gen Shimada, Seiji Ohigashi, Shintaro Sakurai, Akihiro Kishida
INTRODUCTION: The aim of this study was to introduce and examine a modified mechanical end-to-side esophagogastrostomy method ("reverse-Tornado" anastomosis) in laparoscopy-assisted proximal gastrectomy. METHODS: Five patients with gastric cancer who underwent laparoscopy-assisted proximal gastrectomy were analyzed retrospectively. Esophagogastrostomy in the anterior wall was performed in three patients, and esophagogastrostomy in the posterior wall was performed in two patients...
October 21, 2016: Asian Journal of Endoscopic Surgery
P M Jeene, E Versteijne, M I van Berge Henegouwen, J J G H M Bergmann, E D Geijsen, K Muller, H W M van Laarhoven, M C C M Hulshof
The aim of this study was to determine the outcome of salvage definitive chemoradiation (dCRT) for a locoregional recurrence after any prior curative treatment outside previously irradiated areas. Thirty-nine patients treated between January 2005 and December 2014 were reviewed for locoregional recurrent esophageal cancer outside previously irradiated areas. All patients received salvage treatment with external beam radiotherapy (50.4 Gy in 28 fractions) combined with weekly concurrent paclitaxel and carboplatin...
October 21, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Lucas Goense, Peter S N van Rossum, Jelle P Ruurda, Marco van Vulpen, Stella Mook, Gert J Meijer, Richard van Hillegersberg
BACKGROUND: Concerns have been raised regarding the toxicity of neoadjuvant chemoradiotherapy (nCRT) for esophageal cancer that could contribute to an increased risk of postoperative complications. The aim of this study was to determine the influence of the radiation dose to the gastric fundus on the risk of postoperative anastomotic leakage in patients undergoing nCRT followed by transthoracic esophagectomy. METHODS: Between January 2012 and July 2015, 97 consecutive patients who underwent nCRT followed by transthoracic esophagectomy were included in this single-center cohort study...
October 17, 2016: Annals of Thoracic Surgery
Frans van Workum, Stefan A W Bouwense, Misha D P Luyer, Grard A P Nieuwenhuijzen, Donald L van der Peet, Freek Daams, Ewout A Kouwenhoven, Marc J van Det, Frits J H van den Wildenberg, Fatih Polat, Suzanne S Gisbertz, Mark I van Berge Henegouwen, Joos Heisterkamp, Barbara S Langenhoff, Ingrid S Martijnse, Janneke P Grutters, Bastiaan R Klarenbeek, Maroeska M Rovers, Camiel Rosman
BACKGROUND: Currently, a cervical esophagogastric anastomosis (CEA) is often performed after minimally invasive esophagectomy (MIE). However, the CEA is associated with a considerable incidence of anastomotic leakage requiring reintervention or reoperation and moderate functional results. An intrathoracic esophagogastric anastomosis (IEA) might reduce the incidence of anastomotic leakage, improve functional results and reduce costs. The objective of the ICAN trial is to compare anastomotic leakage and postoperative morbidity, mortality, quality of life and cost-effectiveness between CEA and IEA after MIE...
October 18, 2016: Trials
Zensho Ito, Mikio Kajihara, Yasunobu Kobayashi, Tomoya Kanai, Yoshihiro Matsumoto, Kazuki Takakura, Toyokazu Yukawa, Toshifumi Ohkusa, Seita Koyama, Hiroo Imazu, Hiroshi Arakawa, Mitsuru Ohata, Shigeo Koido
Primary hepatic angiosarcoma is a very rare malignancy with a poor prognosis. Because patients present with no specific symptoms, the cancer can grow undetected and most cases are diagnosed too late for resection. We present the case of a 78-year-old Japanese man admitted to our hospital with massive hematemesis and melena. A total gastrectomy had previously been performed on the patient to treat gastric cancer. Endoscopic injection sclerotherapy was performed to control the bleeding from varices over the anastomosis...
May 2016: Case Reports in Gastroenterology
Daisuke Taniguchi, Hiroshi Saeki, Yuichiro Nakashima, Ryosuke Tsutsumi, Sho Nishimura, Kensuke Kudou, Yu Nakaji, Hirotada Tajiri, Satoshi Tsutsumi, Takafumi Yukaya, Ryota Nakanishi, Masahiko Sugiyama, Hideto Sonoda, Kippei Ohgaki, Eiji Oki, Yoshihiko Maehara
A 65-year-old man with cT3N2M0 stage III cervical esophageal cancer underwent subtotal esophagectomy and gastric tube reconstruction through the retrosternal route after neoadjuvant chemoradiotherapy. The anastomosis was located adjacent to the left side of the trachea, and a circular stapler was used for anastomosis. Postoperative anastomotic leakage occurred, and an esophagotracheal fistula between the esophagogastric anastomotic site and cartilage portion of the trachea was observed on postoperative day 44...
December 2016: Surgical Case Reports
Jia Qing Gong, Yong Kuan Cao, Guo Hu Zhang, Pei Hong Wang, Guo De Luo
BACKGROUND: Currently, there is no optimal digestive tract reconstruction technique well recognized by scholars after total gastrectomy. In this study, a new reconstruction method, which is modified from the classic Roux-en-Y procedure, an uncut jejunal esophageal anastomosis with double jejunal pouch (UJEA-DJP) was established, and its advantages for improving the quality of life of patients who undergo total gastrectomy were analyzed. METHODS: Altogether 160 patients with gastric cancer enrolled in our center from September 2009 to March 2012 received radical D2 total gastrectomy...
October 4, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Sang-Yong Son, Long-Hai Cui, Ho-Jung Shin, Cheulsu Byun, Hoon Hur, Sang-Uk Han, Yong Kwan Cho
BACKGROUND: Compared to end-to-side anastomosis with a circular stapler, the overlap method is favored for intracorporeal esophagojejunostomy because it facilitates handling of the stapler, even in narrow spaces, and wider anastomosis. However, it associates with technical difficulties during anastomosis, including difficult traction on the esophageal stump that necessitates stay sutures. Here, we introduce a new modified overlap method that employs knotless barbed sutures (MOBS) and report the outcomes of our case series...
October 3, 2016: Surgical Endoscopy
Lin Zhou, Peng Ge, Jiakuan Chen, Jian Wang, Ming Wang, Xiaofei Li, Tao Jiang
OBJECTIVE: To explore the clinical efficacy and safety of gastroepiploic tunnel esophagogastrostomy applied in minimally invasive esophagectomy and gastroesophageal cervical anastomosis. METHODS: Clinical data of 137 esophageal cancer patients who received minimally invasive esophagectomy from December 2013 to June 2015 in Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University were analyzed retrospectively, including 84 patients receiving anastomosis with tubular anastomat (circular staple group), and 53 patients receiving gastroepiploic tunnel anastomosis(tunnel group, position of tunnel anastomosis located in the side of gastrocolic omentum, about 2-3 cm apart from fundus)...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Xiaofeng Duan, Lei Gong, Xiaobin Shang, Hongjing Jiang, Peng Tang, Zhentao Yu
OBJECTIVE: To study the impact of preoperative fasting plasma glucose(FPG) on postoperative morbidity and outcome following surgical resection of esophageal squamous cell carcinoma (ESCC), and to analyze the risk factor of postoperative complication in ESCC. METHODS: Clinicopathological data of 314 ESCC patients undergoing esophagectomy in our center between January 2011 and December 2012 were retrospectively collected. Patients were divided into two groups according to their preoperative FBG: normal FPG group (FPG<6...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Dong Lin, Ting Ye, Longfei Ma, Longlong Shao, Zuodong Song, Shujun Jiang, Jiaqing Xiang
OBJECTIVE: To compare the safety and efficacy between three-field lymphadenectomy and normative Ivor-Lewis two-field lymphadenectomy for thoracic esophageal squamous cell carcinoma METHODS: Clinical data of 375 patients with thoracic esophageal squamous cell carcinoma who underwent three-field lymphadenectomy(3FL) or Ivor-Lewis two-field lymphadenectomy(2FL, Ivor-Lewis) in Fudan University Shanghai Cancer Center during 2013 were retrieved and collected from electronic medical record system...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Yin Li
Enhanced recovery after surgery (ERAS) is a patient-centered, surgeon-led system combining anesthesia, nursing, nutrition and psychology. It aims to minimize surgical stress and maintain physiological function in perioperative care, thereby expediting recovery. ERAS theory has been clinically applied for nearly 20 years and it is firstly used in colorectal surgery, then widely used in other surgical fields. However, ERAS is not used commonly in esophagectomy because of its surgical complexity and high morbidity of postoperative complications, which limits the application of ERAS in the field of esophagectomy...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Frans van Workum, Jolijn van der Maas, Frits J H van den Wildenberg, Fatih Polat, Ewout A Kouwenhoven, Marc J van Det, Grard A P Nieuwenhuijzen, Misha D Luyer, Camiel Rosman
BACKGROUND: Both cervical esophagogastric anastomosis (CEA) and intrathoracic esophagogastric anastomosis (IEA) are used to restore gastrointestinal integrity following minimally invasive esophagectomy (MIE). No prospective randomized data on functional outcome, postoperative morbidity, and mortality between these techniques are currently available. METHODS: A comparison was conducted including all consecutive patients with esophageal carcinoma of the distal esophagus or gastroesophageal junction undergoing MIE with CEA or MIE with IEA from October 2009 to July 2014 in 3 high-volume esophageal cancer centers...
September 24, 2016: Annals of Thoracic Surgery
Ilan Igor Maizlin, Jerry S Chen, Nicholas James Smith, David A Rogers
Posttraumatic esophagomediastinal fistula is an uncommon clinical entity that warrants surgical awareness due to its life-threatening potential. Its management, especially in previously operated field, is controversial and several endoscopic methods are being proposed as alternatives. Ours is the first report of endoscopic fulguration and fibrin injection in successful closure of such fistula. A 9-year-old female sustained complete tracheoesophageal transection from a gunshot wound to the neck and underwent immediate primary repair...
September 2016: American Surgeon
Yasuaki Nagami, Masatsugu Shiba, Kazunari Tominaga, Masaki Ominami, Shusei Fukunaga, Satoshi Sugimori, Fumio Tanaka, Noriko Kamata, Tetsuya Tanigawa, Hirokazu Yamagami, Toshio Watanabe, Yasuhiro Fujiwara, Tetsuo Arakawa
BACKGROUND AND STUDY AIM: The incidence of stricture formation caused by endoscopic submucosal dissection (ESD) for widespread lesions is high, and stricture formation can reduce quality of life. We evaluated the prophylactic efficacy of hybrid therapy using a locoregional steroid injection and polyglycolic acid (PGA) sheets with fibrin glue to prevent stricture formation after esophageal ESD in high risk patients in whom we predicted stricture formation would be difficult to prevent with a single prophylactic steroid injection...
September 2016: Endoscopy International Open
Dong Jin Kim, Wook Kim
BACKGROUND: Double tract anastomosis (DTA) is a recently revisited reconstruction method for preventing reflux esophagitis in laparoscopy-assisted proximal gastrectomy (LAPG). However, only few studies have shown the advantages of LAPG-DTA. PATIENTS AND METHODS: Seventeen patients underwent LAPG-DTA compared to 17 patients undergoing laparoscopy-assisted total gastrectomy (LATG) matched with preoperative stage. Laboratory results, including hemoglobin, serum ferritin, serum iron and vitamin B12, were compared...
September 2016: Anticancer Research
A A Chernyavsky, N A Lavrov
AIM: to present treatment of patients with gastroesophageal cancer. MATERIAL AND METHODS: 41 cases of esophagogastrectomy with simultaneous intestinal repair were analyzed. There were 37 operations for malignancies and 4 operations for benign diseases. Indications for surgery were defined. Abdominocervical access was predominantly used. In 6 patients esophageal repair was finished by high intrapleural anastomosis due to insufficient length of the graft for cervical anastomosis...
2016: Khirurgiia
Renata Tabola, Katarzyna Augoff, Andrzej Lewandowski, Piotr Ziolkowski, Piotr Szelachowski, Krzysztof Grabowski
A two-stage esophagectomy with an interval for reconstruction of the esophagus creates an opportunity for the esophageal stump to recover from vessel injury and allows the formation of granulation tissue rich in proangiogenic factors, including transforming growth factor β (TGF-β) and vascular endothelial growth factor A (VEGF-A), which may have an impact on anastomosis healing. The present study comprised 25 patients (27 in total, 2 succumbed to complications following surgery) who underwent two-stage esophagectomy for squamous cell carcinoma in the Department of Gastrointestinal and General Surgery, Wrocław Medical University (Wrocław, Poland) between January 2007 and December 2012...
September 2016: Oncology Letters
Robert J Cerfolio, Benjamin Wei, Mary T Hawn, Douglas J Minnich
Minimally invasive esophagectomy with intrathoracic dissection and anastomosis is increasingly performed. Our objectives are to report our operative technique, early results and lessons learned. This is a retrospective review of 85 consecutive patients who were scheduled for minimally invasive Ivor Lewis esophagectomy (laparoscopic or robotic abdominal and robotic chest) for esophageal cancer. Between 4/2011 and 3/2015, 85 (74 men, median age: 63) patients underwent robotic Ivor Lewis esophageal resection. In all, 64 patients (75%) had preoperative chemoradiotherapy, 99% had esophageal cancer, and 99% had an R0 resection...
2016: Seminars in Thoracic and Cardiovascular Surgery
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