Development of a novel technique for esophageal reconstruction via oral-vestibule-enteral anastomosis.

Autor:	Cortés-González R; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México. Electronic address: luisarm.hzf@gmail.com., Hernández Flores LA; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México., Ventosa-Camacho V; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México., Moreno-Licea C; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México., Jaspersen-Álvarez J; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México., Alcázar-Ylizaliturri JL; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México., Del Angel Millán G; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México.
Jazyk:	angličtina
Zdroj:	Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract [J Gastrointest Surg] 2024 Sep; Vol. 28 (9), pp. 1424-1429. Date of Electronic Publication: 2024 Jun 12.
DOI:	10.1016/j.gassur.2024.06.003
Abstrakt:	Background: Narrowing, trauma, tumors, and systemic diseases can cause esophageal dysfunction. Severe cases resist traditional surgery, leading to long-term gastrostomy or jejunostomy tubes, affecting patients negatively. No established surgery ensures both airway and oral function with proper speech. This article introduces the oral-vestibule-enteral anastomosis (OVEA) technique, targeting patients with compromised epiglottic closure competence and loss of cervical esophagus, where conventional methods fall short. Methods: Technique description study evaluated in 13 patients in a single tertiary referral center in Mexico City treated with OVEA from January 1990 to July 2023. Results: Of the 13 patients (69% male; mean age, 37.14 ± 12.907 years), preoperative conditions included a mean body mass index of 17.78 ± 2.66 kg/m 2 , 46% with previous abdominal surgeries, and 31% with a smoking history. After OVEA, complications affected 46%, primarily pneumonia (23%), abscess formations (15%), intestinal necrosis (8%), and airway fistula (8%). Reoperation was needed in 38%, addressing functionality loss, necrosis, stenosis, and jawbone remodeling. No fatalities occurred within the first 6 months after surgery; 84% had successful gastrostomy tube removal, and 8% retained a tracheostomy tube. Currently 13 patients (92%) use the OVEA as their main enteral route of feeding. Conclusion: The OVEA technique seems promising for cases involving esophageal loss or impaired epiglottic function, enhancing patients' quality of life by enabling oral feeding and restoring regular eating habits. Further research should focus on long-term results and identifying optimal candidates for this innovative surgical method. Competing Interests: Declaration of competing interest The authors declare no competing interests. (Copyright © 2024 Society for Surgery of the Alimentary Tract. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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