Complete coverage of in situ aortograft by total omental pedicle flap as the most reliable treatment of aortoesophageal fistula.

Abstract:

:Aortoesophageal fistula secondary to a thoracic aortic aneurysm is usually a fatal disease with few survivors reported previously. We encountered 2 consecutive patients who were treated successfully with esophagectomy and in situ aorta reconstruction using cryopreserved homograft that was wrapped completely with omental pedicle flap. For the construction of omental flap, the right gastroepiploic artery was resected at the root and all the vessels entering the greater curvature and the transverse colon were resected at the adherent edges. Because the gastroepiploic arcade is totally preserved, large amounts of omental tissue could be obtained, with an excellent blood supply mainly from the left gastroepiploic artery. This type of omental flap is highly mobile, easily transferred to the left hemithorax, and has enough volume to cover the in situ aortic graft completely including anastomosis lines. Thus, our omental coverage appears to be the most reliable method to prevent postoperative graft infection.

journal_name

Am J Surg

authors

Kitayama J,Morota T,Kaisaki S,Nakayama H,Ishigami H,Yamashita H,Ishikawa M,Shibata K,Takamoto S,Nagawa H

doi

10.1016/j.amjsurg.2005.09.011

subject

Has Abstract

pub_date

2006-07-01 00:00:00

pages

130-4

issue

1

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(05)00770-1

journal_volume

192

pub_type

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