Gastric conduit revision postesophagectomy: Management for a rare complication

The Journal of Thoracic and Cardiovascular Surgery
Jessica Yu RoveBryan F Meyers

Abstract

Severe postesophagectomy gastric conduit dysfunction refractory to standard endoscopic intervention is rare, with few published reports discussing timing, technique, or results of reoperation. This case series examines assessment and management of severe conduit dysfunction and details techniques for conduit revision. We retrospectively reviewed patients who underwent esophagectomy between September 2008 and October 2015 and studied patients who underwent conduit revision. More than 400 patients underwent Ivor Lewis or transhiatal esophagectomies during this 7-year period. Eight patients underwent reoperation for conduit revision. The strategy for initial anastomosis and management of the pylorus were variable. Symptoms included dysphagia, delayed emptying, aspiration, and weight loss. Evaluation and management included esophagram, computed tomography, repeated esophagoscopy with pyloric intervention, and selective anastomotic dilation. Two patients also had associated paraconduit hiatal hernias. Average time to reoperation was 3.8 years (range 2 weeks to 6.5 years). All revisions were performed through a thoracotomy with either laparoscopy or laparotomy. Revisions were completed in 7 patients. Average length of stay was 9.9 da...Continue Reading

Citations

Jun 21, 2019·Journal of Thoracic Imaging·Diane C StrolloManuel Villa Sanchez
Aug 15, 2020·The Korean Journal of Thoracic and Cardiovascular Surgery·Hee Chul YangJong Mog Lee
Jul 15, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Caroline D AndrewHenning A Gaissert
Aug 5, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Xavier Benoit D'JournoDavid Boulate

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