Esophageal replacement: gastric tube or whole stomach?
Ann Thorac Surg
; 60(2): 261-6; discussion 267, 1995 Aug.
Article
de En
| MEDLINE
| ID: mdl-7646084
ABSTRACT
BACKGROUND:
The stomach can be used either in its entirely or as a greater curvature tube for esophageal replacement.METHODS:
The study compares the gastric tube (group A; n = 112) to the whole stomach whose lesser curvature is denuded (group B; n = 100) in terms of technical complication and alimentary comfort. The clinical results are substantiated by assessment of the eating performance of patients and control subjects at a test meal, measurement of the gastric dimensions before and after both tailoring procedures, and intraarterial staining of the gastric wall.RESULTS:
Major differences between the two groups are cervical anastomosis stenoses (22.3% versus 6% [A versus B]; p = 0.008), fistulas (7.9% versus 1%; p = 0.0209), number of meals and snacks per day (4.6 versus 4; p = 0.0275), sensation of early fullness at meals (52.4% versus 17.8%; p < 0.0001), ratings given to the long-term alimentary comfort (presymptomatic condition = 10 points) (7.6 versus 8.8 out of 10 on average; p < 0.0001), and calories consumed in 1 minute at a test meal (59% [p < 0.05] versus 77% of those consumed by control subjects). The volume of the stomach is reduced by a range of 21.4% to 47.2% after tubulization (group A) whereas it increases by a range of 4.9% to 17.4% after denudation of the lesser curve (group B). Intraarterial staining of the gastric wall reveals the poor vascularity of the upper-most segment of the greater curve.CONCLUSION:
Slight increase of the gastric capacity and maintenance of the submucosal vascular network account for the better results achieved with the whole stomach.
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Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Estomac
/
Tumeurs de l'oesophage
/
Oesophagectomie
Type d'étude:
Observational_studies
Limites:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Langue:
En
Journal:
Ann Thorac Surg
Année:
1995
Type de document:
Article
Pays d'affiliation:
Belgique