1
|
Choi BH, Church J, Sonett J, Kiran RP. Colonic interposition in esophagectomy: an ACS-NSQIP study. Surg Endosc 2023; 37:9563-9571. [PMID: 37730851 DOI: 10.1007/s00464-023-10420-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/29/2023] [Indexed: 09/22/2023]
Abstract
INTRODUCTION For patients with cancer or injury of the esophagus, esophagectomy with reconstruction using the stomach (gastric pull-up, GPU) or colon (colonic interposition, CI) can restore function but is associated with high morbidity. We sought to describe the differences in outcomes between the two replacement organs using a national database. METHODS From ACS-NSQIP, patients who underwent GPU or CI between 2006 and 2020 were identified. Univariate analyses were performed on length of stay, complications, reoperation, readmission, and mortality. Variables with P ≤ 0.2 were included in the multivariate regression. Primary outcomes were 30-day reoperation, readmission, and mortality. Data were assessed using Chi-squared tests and logistic regression. RESULTS There were 12,545 GPU and 502 CI patients. GPU patients were older with higher BMI, and more likely to be male (80.3% versus 70.3%, P < 0.0001) and white (77.8% versus 69.1%, P < 0.0001). More GPU patients had independent functional status and underlying bleeding disorders, but fewer other preoperative comorbidities than CI patients. On univariate analysis, CI patients had longer hospital stays (13 versus 10 days, P < 0.0001); more reoperations (23.9% versus 14.5%, P < 0.0001); a lower rate of discharge to home (70.9% versus 82.1%, P < 0.0001); and a higher mortality rate (6.2% versus 2.9%, P < 0.0001). On multivariate analysis, CI was associated with increased risk of reoperation but not with readmission or mortality. Reoperation was associated with CI, smoking, chronic wound, hypertension, higher ASA class, contaminated or dirty wound class, and longer operative time. Readmission was associated with female gender, hypertension, and longer operative time. Mortality was associated with age, metastatic cancer, preoperative sepsis, preoperative renal failure, malignant esophageal disease, higher ASA class, incomplete closure, and longer operative time. CONCLUSION Colonic interposition, although a more difficult option with traditionally worse outcomes, should still be considered for patients requiring esophagectomy if the stomach cannot be used to restore continuity, as differences in outcomes appear to be due to underlying frailty of patients rather than the procedure.
Collapse
Affiliation(s)
- Beatrix Hyemin Choi
- Colorectal Surgery, Columbia University Irving Medical Center/New York Presbyterian Hospital, 161 Ft. Washington Avenue, Floor 8, New York, NY, 10032, USA.
| | - James Church
- Colorectal Surgery, Columbia University Irving Medical Center/New York Presbyterian Hospital, 161 Ft. Washington Avenue, Floor 8, New York, NY, 10032, USA
| | - Joshua Sonett
- Thoracic Surgery, Columbia University Irving Medical Center/New York Presbyterian Hospital, 161 Ft. Washington Avenue, Floor 3, New York, NY, 10032, USA
| | - Ravi Pokala Kiran
- Colorectal Surgery, Columbia University Irving Medical Center/New York Presbyterian Hospital, 161 Ft. Washington Avenue, Floor 8, New York, NY, 10032, USA
| |
Collapse
|
2
|
Roussel E, Papet E, Chati R, Schwarz L, Tuech JJ, Huet E. When Gastroplasty Is Not Feasible in Ivor Lewis Esophagectomy: A Single-Center Study of Intrathoracic Esophagojejunostomy. J Laparoendosc Adv Surg Tech A 2023; 33:1102-1108. [PMID: 37792402 DOI: 10.1089/lap.2023.0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
Objective: The surgical management of tumors of the esophagogastric junction is increasingly performed by minimally invasive Ivor Lewis esophagectomy. However, gastroplasty is not always feasible. The creation of a long loop is an alternative for esophageal reconstruction. The aim of this study was to evaluate the technical feasibility of using a minimally invasive thoracoscopic approach in esophagojejunostomy and to describe the contraindications for gastroplasty. Methods: All patients who had intrathoracic esophagojejunostomy in our center were identified in our database. Since 2016, the preferred approach for intrathoracic esophagojejunostomy is minimally invasive laparoscopy and thoracoscopy, using a long Roux-en-Y jejunal loop with a semimechanical triangular anastomosis technique. Results: Between January 1, 2012 and January 1, 2022, 12 patients who had esophagojejunostomy in our center were included in the study. Among them, 6 had thoracotomy and 6 had total minimally invasive thoracoscopy, representing 3.5% of surgical procedures for esophagogastric junction tumors since 2016. The mean operative time was 416.9 ± 107.47 minutes. No anastomotic leakage was observed in the minimally invasive group versus 2 leakages in the thoracotomy group. The main complication was pneumonia in 3 patients (27.3%). Finally, the main indication for intrathoracic esophagojejunostomy was tumor size with a mean of 4.72 ± 2.35 cm and the patient's surgical history. Conclusion: A total minimally invasive approach using a long jejunal loop with triangular anastomosis could be a feasible and reproducible alternative to gastroplasty to restore continuity in Ivor Lewis esophagectomy when the stomach cannot be used.
Collapse
Affiliation(s)
| | - Eloise Papet
- Department of Digestive Surgery, CHU Rouen, Rouen, France
| | - Rachid Chati
- Department of Digestive Surgery, CHU Rouen, Rouen, France
| | - Lilian Schwarz
- Department of Digestive Surgery, CHU Rouen, Rouen, France
| | | | - Emmanuel Huet
- Department of Digestive Surgery, CHU Rouen, Rouen, France
| |
Collapse
|
3
|
YANKOV GS, MEKOV EV, VLADIMIROV BG, KOVACHEVA-SLAVOVA MD. Management of series of complications after a laparoscopic Nissen fundoplication. Chirurgia (Bucur) 2023. [DOI: 10.23736/s0394-9508.22.05425-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
|
4
|
Long term outcome of a subcutaneous colonic interposition after pharyngo-laryngectomy for strictures of the larynx and hypopharynx resulting from caustic ingestion: A case report. Int J Surg Case Rep 2022; 95:107215. [PMID: 35609478 PMCID: PMC9126773 DOI: 10.1016/j.ijscr.2022.107215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/15/2022] [Accepted: 05/15/2022] [Indexed: 11/22/2022] Open
|
5
|
Kumar SP, Ahmed Z, M RR, Shetty MG, Rao GV, Subramanyeshwar Rao T, Rebala P. Indocyanine Green Near Infrared Fluorescence Imaging for Colonic Conduit Perfusion Assessment in Colon Pull-up for Corrosive Oesophageal Strictures. Indian J Surg 2022. [DOI: 10.1007/s12262-022-03317-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
6
|
Flemming S, Lock JF, Hankir M, Reimer S, Petritsch B, Germer CT, Seyfried F. Successful management of therapy-refractory pseudoachalasia after Ivor Lewis esophagectomy by bypassing colonic pull-up: A case report. World J Clin Cases 2021; 9:3971-3978. [PMID: 34141755 PMCID: PMC8180226 DOI: 10.12998/wjcc.v9.i16.3971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/26/2021] [Accepted: 03/24/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gastric pull-up after esophagectomy is still a demanding surgical procedure and associated with considerable morbidity such as anastomotic leaks, fistulas or stenoses. These complications are usually managed by endoscopy, but in extreme cases multidisciplinary management including reoperations may be necessary. Here, we report managing therapy-refractory pseudoachalasia after Ivor Lewis esophagectomy by bypassing colonic pull-up.
CASE SUMMARY A 70-year-old male with dysphagia and regurgitation after esophagectomy with gastric pull-up reconstruction was transferred to our tertiary hospital. Since endoscopic approaches including balloon dilatation and stenting failed, retrosternal colonic pull-up with Roux-en-Y reconstruction was performed with no subsequent adverse events.
CONCLUSION Secondary colonic pull-up is a demanding but successful surgical procedure in patients suffering from therapy-refractory complaints after esophagectomy with gastric pull-up reconstruction.
Collapse
Affiliation(s)
- Sven Flemming
- Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, Würzburg 97080, Germany
| | - Johan F Lock
- Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, Würzburg 97080, Germany
| | - Mohammed Hankir
- Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, Würzburg 97080, Germany
| | - Stanislaus Reimer
- Department of Internal Medicine II, Section of Gastroenterology, University Hospital of Wuerzburg, Würzburg 97080, Germany
| | - Bernhard Petritsch
- Department of Diagnostic and Interventional Radiology, University Hospital of Wuerzburg, Würzburg 97080, Germany
| | - Christoph-Thomas Germer
- Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, Würzburg 97080, Germany
| | - Florian Seyfried
- Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, Würzburg 97080, Germany
| |
Collapse
|
7
|
Rentea RM, Halleran DR, Ahmad H, Sanchez AV, Gasior AC, McCracken K, Hewitt GD, Alexander V, Smith C, Weaver L, Wood RJ, Levitt MA. Preliminary Use of Indocyanine Green Fluorescence Angiography and Value in Predicting the Vascular Supply of Tissues Needed to Perform Cloacal, Anorectal Malformation, and Hirschsprung Reconstructions. Eur J Pediatr Surg 2020; 30:505-511. [PMID: 31858494 DOI: 10.1055/s-0039-1700548] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Reconstructive techniques for cloaca, anorectal malformations (ARM), and Hirschsprung disease (HD) may require intestinal flaps on vascular pedicles for vaginal reconstruction and/or colonic pull-throughs. Visual assessment of tissue perfusion is typically the only modality used. We investigated the utility of intraoperative indocyanine green fluorescence angiography (ICG-FA) and hypothesized that it would be more accurate than the surgeon's eye. MATERIALS AND METHODS Thirteen consecutive patients undergoing cloacal reconstruction (9), HD (3), and ARM repair (1) underwent ICG-FA laser SPY imaging to assess colonic, rectal, vaginal, and neovaginal tissue perfusion following intraoperative visual clinical assessment. Operative findings were correlated with healing at 6 weeks, 3 months, and 1 year postoperatively. RESULTS ICG-FA resulted in a change in the operative plan in 4 of the 13 (31%) cases. In three cases, ICG-FA resulted in the distal bowel being transected at a level (>10 cm) higher than originally planned, and in one case the distal bowel was discarded, and the colostomy used for pull-through. CONCLUSION ICG-FA correctly identified patients who might have developed a complication from poor tissue perfusion. Employing this technology to assess rectal or neovaginal pull-throughs in cloacal reconstructions, complex HD, and ARM cases may be a valuable technology.
Collapse
Affiliation(s)
- Rebecca Maria Rentea
- Center for Pelvic and Colorectal Reconstruction, Nationwide Children's Hospital, Columbus, Ohio, United States.,Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States
| | - Devin R Halleran
- Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States
| | - Hira Ahmad
- Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States
| | - Alejandra Vilanova Sanchez
- Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States.,Department of Pediatric Surgery, University Hospital La Paz, Madrid, Spain
| | - Alessandra C Gasior
- Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States
| | - Katherine McCracken
- Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States
| | - Geri D Hewitt
- Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States
| | - Victoria Alexander
- Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States
| | - Caitlin Smith
- Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States
| | - Laura Weaver
- Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States
| | - Richard J Wood
- Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States
| | - Marc A Levitt
- Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States
| |
Collapse
|
8
|
Rentea RM, Badillo AT, Hosie S, Sutcliffe JR, Dickie B. Lasting impact on children with an anorectal malformations with proper surgical preparation, respect for anatomic principles, and precise surgical management. Semin Pediatr Surg 2020; 29:150986. [PMID: 33288132 DOI: 10.1016/j.sempedsurg.2020.150986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Optimal outcomes in the management of children with Anorectal Malformation (ARM) require careful surgical preparation and detailed understanding of the anatomic principles and operative setup. A clear understanding of operative anatomy and surgical principals guides decision making. Adherence to the principles of ARM repair, as well as the application of operative and imaging adjuncts, will yield the safest and most successful approach to ARM. In this review, we detail the surgical preparation, anatomic principles, and surgical management issues unique to ARM.
Collapse
Affiliation(s)
- Rebecca M Rentea
- Comprehensive Colorectal Center, Department of Surgery, Children's Mercy-Kansas City, Kansas City, MO 64108, USA.
| | - Andrea T Badillo
- Divisions of Pediatric Surgery and Colorectal and Pelvic Reconstruction, Children's National Hospital, Washington, DC, USA
| | - Stuart Hosie
- Department of Pediatric Surgery, Stadtisches Kinikum Munchen GmBH, Munich, Germany
| | - Jonathan R Sutcliffe
- Department of Pediatric Surgery, Leeds General Infirmary, Leeds LS1 3EX, United Kingdom
| | - Belinda Dickie
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| |
Collapse
|
9
|
Isozaki T, Murakami K, Yamanouchi E, Uesato M, Toyozumi T, Koide Y, Tsukamoto S, Sakata H, Hayano K, Kano M, Hayashi H, Matsubara H. Magnetic compression anastomosis is effective in treating stenosis after esophageal cancer surgery: a case report. Surg Case Rep 2020; 6:213. [PMID: 32804348 PMCID: PMC7431484 DOI: 10.1186/s40792-020-00974-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Esophagostomy is important in the treatment of esophageal cancer. However, esophagectomy has a higher risk of postoperative complications. Treatment for complications is often difficult, and in some cases, oral intake is no longer possible. Recently, magnetic compression anastomosis (MCA) was developed; it is a relatively safe method of anastomosis that does not require surgery in patients with stricture, obstruction, or dehiscence of the anastomosis after surgery. CASE PRESENTATION The patient was a 76-year-old Japanese man. He underwent esophagectomy with a three-field dissection for esophageal cancer. A cervical esophagostomy and chest drainage were performed for necrosis of the gastric tube. Following infection control, colon interposition was performed. However, after the operation, the colon necrotized and formed an abscess. Drainage controlled the infection, but the colon was completely obstructed. The patient was referred to our hospital to restore oral ingestion. Contrast studies showed that the length of the occlusion was 10 mm. The reconstruction was examined; reanastomosis by surgery was judged to be a high risk, so the strategy of anastomosis by MCA was adopted. In the operation, the anterior chest was opened to expose the colon, and a magnet was inserted directly into the blind end of the colon. The magnet was guided to the blind end of the esophagus using an oral endoscope. Two weeks after MCA, a contrast study confirmed the passage of the contrast agent from the esophagus to the colon. The patient eventually took 18 bougies after the MCA. However, since then, he has not needed a bougie. As of 1 year and 8 months after the MCA, the patient is living at home with oral intake restored. CONCLUSIONS MCA is an effective and safe treatment for complete stenosis after esophageal cancer surgery.
Collapse
Affiliation(s)
- Tetsuro Isozaki
- Department of Frontier Surgery Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan.
| | - Kentaro Murakami
- Department of Frontier Surgery Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Eigoro Yamanouchi
- Department of Radiology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara-shi, Tochigi, 329-2763, Japan
| | - Masaya Uesato
- Department of Frontier Surgery Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Takeshi Toyozumi
- Department of Frontier Surgery Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Yoshio Koide
- Department of Surgery, Yarita Hospital, 899 Goi, Ichihara-shi, Chiba, 290-0056, Japan
| | - Soichiro Tsukamoto
- Department of Surgery, Yarita Hospital, 899 Goi, Ichihara-shi, Chiba, 290-0056, Japan
| | - Haruhito Sakata
- Department of Frontier Surgery Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Koichi Hayano
- Department of Frontier Surgery Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Masayuki Kano
- Department of Frontier Surgery Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Hideki Hayashi
- Department of Frontier Surgery Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Hisahiro Matsubara
- Department of Frontier Surgery Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| |
Collapse
|
10
|
Pisani S, Croce S, Chiesa E, Dorati R, Lenta E, Genta I, Bruni G, Mauramati S, Benazzo A, Cobianchi L, Morbini P, Caliogna L, Benazzo M, Avanzini MA, Conti B. Tissue Engineered Esophageal Patch by Mesenchymal Stromal Cells: Optimization of Electrospun Patch Engineering. Int J Mol Sci 2020; 21:ijms21051764. [PMID: 32143536 PMCID: PMC7084816 DOI: 10.3390/ijms21051764] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 12/16/2022] Open
Abstract
Aim of work was to locate a simple, reproducible protocol for uniform seeding and optimal cellularization of biodegradable patch minimizing the risk of structural damages of patch and its contamination in long-term culture. Two seeding procedures are exploited, namely static seeding procedures on biodegradable and biocompatible patches incubated as free floating (floating conditions) or supported by CellCrownTM insert (fixed conditions) and engineered by porcine bone marrow MSCs (p-MSCs). Scaffold prototypes having specific structural features with regard to pore size, pore orientation, porosity, and pore distribution were produced using two different techniques, such as temperature-induced precipitation method and electrospinning technology. The investigation on different prototypes allowed achieving several implementations in terms of cell distribution uniformity, seeding efficiency, and cellularization timing. The cell seeding protocol in stating conditions demonstrated to be the most suitable method, as these conditions successfully improved the cellularization of polymeric patches. Furthermore, the investigation provided interesting information on patches’ stability in physiological simulating experimental conditions. Considering the in vitro results, it can be stated that the in vitro protocol proposed for patches cellularization is suitable to achieve homogeneous and complete cellularizations of patch. Moreover, the protocol turned out to be simple, repeatable, and reproducible.
Collapse
Affiliation(s)
- Silvia Pisani
- Department of Drug Sciences, University of Pavia, 27100 Pavia, Italy; (S.P.); (E.C.); (I.G.); (B.C.)
| | - Stefania Croce
- Department of Clinical, Surgical, Diagnostic & Pediatric Sciences, University of Pavia, IRCCS Policlinico S. Matteo, 27100 Pavia, Italy; (S.C.); (L.C.)
| | - Enrica Chiesa
- Department of Drug Sciences, University of Pavia, 27100 Pavia, Italy; (S.P.); (E.C.); (I.G.); (B.C.)
| | - Rossella Dorati
- Department of Drug Sciences, University of Pavia, 27100 Pavia, Italy; (S.P.); (E.C.); (I.G.); (B.C.)
- Correspondence:
| | - Elisa Lenta
- Department of Paediatric Oncoaematology, IRCCS Policlinico S. Matteo, 27100 Pavia, Italy; (E.L.); (M.A.A.)
| | - Ida Genta
- Department of Drug Sciences, University of Pavia, 27100 Pavia, Italy; (S.P.); (E.C.); (I.G.); (B.C.)
| | - Giovanna Bruni
- Department of Chemistry, University of Pavia, 27100 Pavia, Italy;
| | - Simone Mauramati
- Department of Surgery, Otolaryngologist section, IRCCS Policlinico S. Matteo, 27100 Pavia, Italy; (S.M.); (M.B.)
| | - Alberto Benazzo
- Department of Surgery, Medical University of Vienna, 1090 Vienna, Austria;
| | - Lorenzo Cobianchi
- Department of Clinical, Surgical, Diagnostic & Pediatric Sciences, University of Pavia, IRCCS Policlinico S. Matteo, 27100 Pavia, Italy; (S.C.); (L.C.)
| | - Patrizia Morbini
- Department of Diagnostic Medicine, IRCCS Policlinico S. Matteo, 27100 Pavia, Italy;
| | - Laura Caliogna
- Orthopaedic and Traumatology, IRCCS Policlinico San Matteo, 27100 Pavia, Italy;
| | - Marco Benazzo
- Department of Surgery, Otolaryngologist section, IRCCS Policlinico S. Matteo, 27100 Pavia, Italy; (S.M.); (M.B.)
| | - Maria Antonietta Avanzini
- Department of Paediatric Oncoaematology, IRCCS Policlinico S. Matteo, 27100 Pavia, Italy; (E.L.); (M.A.A.)
| | - Bice Conti
- Department of Drug Sciences, University of Pavia, 27100 Pavia, Italy; (S.P.); (E.C.); (I.G.); (B.C.)
| |
Collapse
|
11
|
Low DE, Allum W, De Manzoni G, Ferri L, Immanuel A, Kuppusamy M, Law S, Lindblad M, Maynard N, Neal J, Pramesh CS, Scott M, Mark Smithers B, Addor V, Ljungqvist O. Guidelines for Perioperative Care in Esophagectomy: Enhanced Recovery After Surgery (ERAS®) Society Recommendations. World J Surg 2018; 43:299-330. [DOI: 10.1007/s00268-018-4786-4] [Citation(s) in RCA: 239] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
12
|
Gust L, De Lesquen H, Bouabdallah I, Brioude G, Thomas PA, D'journo XB. Peculiarities of intra-thoracic colon interposition-eso-coloplasty: indications, surgical management and outcomes. ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:41. [PMID: 29610733 DOI: 10.21037/atm.2017.06.10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Stomach is the usual organ of choice for oesophageal replacement. Gastric pull-up is a standardized, fast and secure procedure, requiring only one anastomosis and usually performed with mini-invasive techniques. Colon is used when the stomach is not available, for tumours of the upper oesophagus or the hypopharynx, for benign or paediatric diseases. It is a complex surgery requiring a specific pre-operative management, three or four anastomoses, and a careful choice of the route of reconstruction. Early post-operative complications, such as anastomotic leakage, are frequent. Long-term outcomes are marked by strictures of the anastomosis and redundancy, but the reported quality of life of the patients is good. Eso-coloplasty remains a safe and feasible alternative to gastric pull-up for oesophageal replacement, for specific indications.
Collapse
Affiliation(s)
- Lucile Gust
- Department of Thoracic Surgery, Disease of the Oesophagus and Lung Transplantation, North Hospital, Aix-Marseille University, Marseille, France
| | - Henri De Lesquen
- Department of Thoracic and Vascular Surgery, Sainte Anne Military Teaching Hospital, Toulon, France
| | - Ilies Bouabdallah
- Department of Thoracic Surgery, Disease of the Oesophagus and Lung Transplantation, North Hospital, Aix-Marseille University, Marseille, France
| | - Geoffrey Brioude
- Department of Thoracic Surgery, Disease of the Oesophagus and Lung Transplantation, North Hospital, Aix-Marseille University, Marseille, France
| | - Pascal-Alexandre Thomas
- Department of Thoracic Surgery, Disease of the Oesophagus and Lung Transplantation, North Hospital, Aix-Marseille University, Marseille, France
| | - Xavier-Benoit D'journo
- Department of Thoracic Surgery, Disease of the Oesophagus and Lung Transplantation, North Hospital, Aix-Marseille University, Marseille, France
| |
Collapse
|
13
|
Mungo B, Barbetta A, Lidor AO, Stem M, Molena D. Laparoscopic retrosternal gastric pull-up for fistulized mediastinal mass. World J Gastrointest Surg 2017; 9:92-96. [PMID: 28396722 PMCID: PMC5366931 DOI: 10.4240/wjgs.v9.i3.92] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 11/12/2016] [Accepted: 01/18/2017] [Indexed: 02/06/2023] Open
Abstract
We describe the case of a patient successfully reconstructed with laparoscopic retrosternal gastric pull-up after esophagectomy for unresectable posterior mediastinal inflammatory myofibroblastic tumor, eroding into the esophagus and compressing the airways. A partial esophagectomy with esophagostomy was performed for treatment of esophageal pleural fistula and empyema, while the airways were managed with the placement of an endobronchial stent. Gastrointestinal reconstruction was performed using a laparoscopic approach to create a retrosternal tunnel for gastric conduit pull-up and cervical anastomosis. The patient was discharged uneventfully after 6 d, and has done very well at home with normal diet.
Collapse
|