Classification and early recognition of gastric conduit failure after minimally invasive esophagectomy
| Autor: | Darmarajah Veeramootoo, Peter Froeschle, Martin Cooper, Rajeev Parameswaran, Richard G. Berrisford, Rakesh Krishnadas, Shahjehan A. Wajed |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty Esophageal Neoplasms medicine.medical_treatment Jejunostomy Adenocarcinoma Severity of Illness Index Necrosis Postoperative Complications Ischemia Stomach Neoplasms Gastric Stump medicine Humans Thoracotomy Prospective Studies Esophagus Prospective cohort study Laparoscopy Aged Aged 80 and over medicine.diagnostic_test business.industry Anastomosis Surgical Middle Aged Surgery Esophagectomy medicine.anatomical_structure C-Reactive Protein Early Diagnosis Carcinoma Squamous Cell Lymph Node Excision Female Esophagoscopy business Complication Esophagostomy Abdominal surgery |
| Zdroj: | Surgical endoscopy. 23(9) |
| ISSN: | 1432-2218 |
| Popis: | Esophagectomy is a high-risk procedure, with significant morbidity resulting from gastric conduit failure. Early recognition and management of these complications is essential. This study aimed to investigate the clinical value of routine investigations after minimally invasive esophagectomy (MIO) and to propose a classification system for gastric conduit failure. For esophagogastric resection, MIO is the procedure of choice in the authors’ unit. Standard postoperative care similar to that for open esophagectomy is undertaken on a specialist ward. Routine investigations include daily assessment of C-reactive protein (CRP), white cell count (WCC), and a contrast swallow on postoperative day (POD) 5. The authors performed a retrospective analysis to assess the utility of these tests. Of a prospective cohort of 50 patients from April 2004 to July 2006, 26 (52%) had an uneventful recovery (U), 24 (48%) experienced complications (C) of varying nature and severity, and 1 died (2%). All the patients demonstrated a transient abnormal rise in CRP until POD 3. In group U, the levels then fell, but in group C, they remained elevated (POD 5: U = 96, C = 180; p |
| Databáze: | OpenAIRE |
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