Conduit Vascular Evaluation is Associated with Reduction in Anastomotic Leak After Esophagectomy

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Chase CampbellJonathan C Salo

Abstract

Anastomotic leak following esophagectomy is associated with significant morbidity and mortality. A major factor determining anastomotic success is an adequate blood supply to the conduit. The aim of this study was to determine the impact of intraoperative evaluation of the conduit's vascular supply on anastomotic failure after esophagectomy. We retrospectively analyzed data from 90 consecutive patients undergoing esophagectomy with gastric conduit reconstruction. A change in surgical practice occurred after 60 cases were completed, when we introduced the use of intraoperative indocyanine green fluorescence angiography and Doppler examination to evaluate blood supply and assist in construction of the conduit. The leak rates before and after implementation of conduit vascular evaluation were compared. After the introduction of intraoperative vascular evaluation of the gastric conduit, we noted a dramatic decrease in the rate of anastomotic leak from 20 % in the first 60 patients to 0 % in the succeeding 30 patients. Intraoperative vascular evaluation with indocyanine green fluorescence imaging and Doppler examination of the gastric conduit used to assist reconstruction after esophagectomy allows for enhanced construction of the c...Continue Reading

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Citations

Sep 24, 2015·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Michael J Stamos
May 21, 2015·The Journal of Thoracic and Cardiovascular Surgery·Michael I Ebright
Apr 27, 2016·The Annals of Thoracic Surgery·Lucas GoenseEwout A Kouwenhoven
Sep 18, 2016·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Sami A ChadiSteven D Wexner
Jun 25, 2017·The Journal of Thoracic and Cardiovascular Surgery·Shamus R Carr
Aug 18, 2017·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Francisco Schlottmann, Marco G Patti
Jun 26, 2018·Journal of Surgical Oncology·Labrinus van ManenJan Sven David Mieog
Jan 10, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Benjamin M MotzJonathan C Salo
Nov 2, 2018·Annals of Surgical Oncology·Patrick D LorimerJonathan C Salo
Feb 3, 2016·Abdominal Radiology·Ryan A MakarTracy A Jaffe
Jul 17, 2019·Surgical Endoscopy·Manuel BarberioMichele Diana
Sep 1, 2019·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·A DupréeO Mann
Feb 19, 2020·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·Yusef MoullaInes Gockel
Sep 19, 2020·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·Kevin J WalshDavid Amar
Jun 28, 2019·Medical & Biological Engineering & Computing·Haryadi PrasetyaEd van Bavel
Aug 15, 2020·The Korean Journal of Thoracic and Cardiovascular Surgery·Yu Hua QuanHyun Koo Kim
Oct 14, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Olugbenga T OkusanyaInderpal S Sarkaria
Mar 29, 2019·World Journal of Gastrointestinal Oncology·Elke Van DaelePiet Pattyn
Oct 20, 2020·Annals of Surgical Oncology·S Michael GriffinAlexander W Phillips
Oct 23, 2020·Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia·Wenda GaoZiqiang Tian

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