PS01.163: EVALUATION OF A TECHNIQUE OF SINGLE LAYER CONTINUOUS ESOPHAGOGASTRIC ANASTOMOSIS USING POLIGLECAPRONE 25

Autor: Sanjeev Parshad, R. K. Karwasra, Ravinder Kumar
Rok vydání: 2018
Předmět:
Zdroj: Diseases of the Esophagus. 31:95-95
ISSN: 1442-2050
1120-8694
DOI: 10.1093/dote/doy089.ps01.163
Popis: Background Methods This was a prospective study on patients who underwent esophagectomy for carcinoma oesophagus from May 2016 to August 2017. The patients who expired in immediate post operative period were excluded from study for evaluation of anastomotic leak and those patients who could not be followed up for at least six months were also excluded from study for evaluation of development of post operative stricture. End to side anastomosis was placed on the anterior surface of stomach using two suture lengths of 2–0 polyglecaprone 25. Anastomosis was done in single continuous layer with full thickness bites. At the end the stomach conduit was tucked to prevertebral fascia by a single stitch. During post operative period, Jejunal feeding was started on 2nd post operative day. Ryle's tube was removed on 5th post operative day and clear liquids were started. Gastrograffin study was done only if clinical suspicion of leak was there on day 7. Semisolid puree diet was started on day 7 and neck drain was removed on day 10. Patients were followed up for six months and specifically asked for symptoms of dysphagia.Symptoms of dysphagia were recorded and graded on the basis of Mellow-Pinkas scoring system. Results Mckeowns esophagectomy was performed in 18 patients, transhiatal in 8 patients and Ivor Lewis in 1 patient. Average time taken for anastomosis was 17 min. Anastomotic leak was seen in four patients(14.81%) and all leaks could be managed conservatively. Only two patients(7.40%) presented with dysphagia which required dilatations. The cost of suture used was least as compared to other techniques. Conclusion Anastomotic leak rate of the present technique was found to be comparable to other techniques whereas the post operative stricture formation was significantly less. Poliglecaprone 25 looses all its tensile strength by third week and this may be the reason for low stricture rates. We conclude that Esophagogastic anastomosis with a single layer continuous technique using 2–0 poliglicaprone 25 gives good results having comparable leak rates to other techniques. The rate of anastomotic stricture formation is quite low as compared to other techniques.The anastomosis takes less than seventeen minutes and is quite cost effective. Disclosure All authors have declared no conflicts of interest.
Databáze: OpenAIRE
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