Importance of additional microvascular anastomosis in esophageal reconstruction after salvage esophagectomy.

Abstract:

:Esophageal reconstruction after salvage esophagectomy in patients who have undergone curative-intent chemoradiotherapy for esophageal cancer is associated with a significant risk of perioperative morbidity and mortality. In particular, anastomotic leakage can cause severe and potentially fatal complications, including mediastinitis and pneumonia. The authors performed esophageal reconstruction with a pedicled right colon graft after salvage esophagectomy in eight patients. To decrease the rate of anastomotic leakage, the authors performed an additional microvascular anastomosis at the distal end of the graft. The distal stumps of the ileocolic artery and vein were anastomosed to the cervical vessels. After surgery, aspiration pneumonia and localized wound infection were observed in two patients each, but slight anastomotic leakage was observed in only one patient. Postoperative swallowing function was satisfactory in all patients. Although the incidence of anastomotic leakage is reportedly high, the authors observed anastomotic leakage in only one of eight patients. The authors believe that additional microvascular anastomosis helps prevent anastomotic leakage, especially in patients who have undergone salvage esophagectomy after curative chemoradiotherapy.

journal_name

Plast Reconstr Surg

authors

Sakuraba M,Kimata Y,Hishinuma S,Nishimura M,Gotohda N,Ebihara S

doi

10.1097/01.prs.0000122211.29839.fe

subject

Has Abstract

pub_date

2004-06-01 00:00:00

pages

1934-9

issue

7

eissn

0032-1052

issn

1529-4242

journal_volume

113

pub_type

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