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Redefining Esophagectomy: The Manual Layered Insertion Method That May Reduce Anastomotic Leakage.
He, Xuedong; Mao, Tianqin; Peng, Lin; Wang, Shiping; Deng, Tao; He, Wenwu.
Afiliação
  • He X; Department of Thoracic Surgery, The People's Hospital of Jianyang City, Jianyang, Sichuan, China.
  • Mao T; Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Cancer Hospital Affiliated to University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
  • Peng L; Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Cancer Hospital Affiliated to University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
  • Wang S; Department of Thoracic Surgery, The People's Hospital of Jianyang City, Jianyang, Sichuan, China.
  • Deng T; Department of Thoracic Surgery, The People's Hospital of Jianyang City, Jianyang, Sichuan, China.
  • He W; Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Cancer Hospital Affiliated to University of Electronic Science and Technology of China, Chengdu, Sichuan, China. Electronic address: wenwu_he@126.com.
J Surg Res ; 296: 182-188, 2024 Apr.
Article em En | MEDLINE | ID: mdl-38277955
ABSTRACT

INTRODUCTION:

Anastomotic leakage post-esophagectomy remains a significant challenge. Despite the use of both mechanical and manual anastomosis, leakage rates remain high. This study evaluated the effectiveness of the manual layered insertion anastomosis technique in addressing this issue.

METHODS:

A retrospective analysis was conducted on patients who underwent this technique from September 2020 to December 2021. The process involved thoracoscopic release of the esophagus, mediastinal lymph node dissection, laparoscopic stomach release, and its transformation into a tube. The latter was then guided to the neck for anastomosis. The posterior anastomotic wall was reshaped in the neck first for optimal insertion, followed by layered suturing with the gastric conduit. The anterior wall was subsequently sutured and repositioned into the chest.

RESULTS:

The study included 56 patients (51 men, five women, mean age 65.4 y), with nine having undergone neoadjuvant therapy. All received minimally invasive esophagectomy. Average intraoperative blood loss was 79.8 mL, operation time averaged 331 min, and feeding resumed after an average of 6.3 d. No anastomotic leakages were reported, with reduced incidences of anastomotic stenosis and gastric acid reflux compared to previous studies.

CONCLUSIONS:

The manual layered insertion anastomosis technique may reduce anastomotic leakage and associated complications, improving the efficacy of esophagectomy, which may improve postoperative results and patient quality of life, suggesting the method's potential suitability for wider clinical application.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Esofágicas / Fístula Anastomótica Tipo de estudo: Guideline Limite: Aged / Female / Humans / Male Idioma: En Revista: J Surg Res Ano de publicação: 2024 Tipo de documento: Article País de afiliação: China

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Esofágicas / Fístula Anastomótica Tipo de estudo: Guideline Limite: Aged / Female / Humans / Male Idioma: En Revista: J Surg Res Ano de publicação: 2024 Tipo de documento: Article País de afiliação: China