Ileo-right colonic reconstruction preserving all four colonic vessels after esophagectomy for cancer
Autor: | Masaru Komatsu, Shiori Utsumi, Makoto Aoki, Hiroaki Uehara, Kazuaki Kobayashi, Rina Harada, Akira Kubota, Shirou Kuwabara |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Esophageal Neoplasms Colon business.industry medicine.medical_treatment Anastomosis Surgical Cancer Esophageal cancer medicine.disease digestive system diseases Surgery Surgical methods Subcutaneous route Esophagectomy Ileum Anastomotic leakage Microvascular anastomosis medicine Humans Blood supply business |
Zdroj: | Updates in Surgery. 73:2239-2246 |
ISSN: | 2038-3312 2038-131X |
Popis: | When colonic graft is used as an esophageal substitute after esophagectomy, one or two feeding vessels of the colon are cut to obtain sufficient length, the graft is passed via the subcutaneous route, and microvascular anastomosis is often used to avoid fatal complications. Sixteen consecutive ileo-right colonic reconstructions via the posterior mediastinal or retrosternal route with preservation of all four colonic vessels were performed in the past eight years. We presented the surgical technique and evaluation of this surgical method. In 15 out of 16 consecutive cases, the graft could be pulled up to the neck through the posterior mediastinal or retrosternal route while preserving all four colonic vessels. Reconstruction was not possible in one patient because of ileocolic vessel injury during colonic mobilization. Anastomotic leakage occurred in three patients, but all were minor and were treated conservatively. There were no patients with graft necrosis resulting from insufficient blood supply. Ileo-right colonic reconstruction with preservation of all four colonic vessels through the posterior mediastinal or retrosternal route is a safe and feasible procedure and is considered the first choice for colonic reconstruction as an esophageal substitute. |
Databáze: | OpenAIRE |
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