Importance of additional microvascular anastomosis in esophageal reconstruction after salvage esophagectomy

Plastic and Reconstructive Surgery
Minoru SakurabaSatoshi Ebihara

Abstract

Esophageal reconstruction after salvage esophagectomy in patients who have undergone curative-intent chemoradiotherapy for esophageal cancer is associated with a significant risk of perioperative morbidity and mortality. In particular, anastomotic leakage can cause severe and potentially fatal complications, including mediastinitis and pneumonia. The authors performed esophageal reconstruction with a pedicled right colon graft after salvage esophagectomy in eight patients. To decrease the rate of anastomotic leakage, the authors performed an additional microvascular anastomosis at the distal end of the graft. The distal stumps of the ileocolic artery and vein were anastomosed to the cervical vessels. After surgery, aspiration pneumonia and localized wound infection were observed in two patients each, but slight anastomotic leakage was observed in only one patient. Postoperative swallowing function was satisfactory in all patients. Although the incidence of anastomotic leakage is reportedly high, the authors observed anastomotic leakage in only one of eight patients. The authors believe that additional microvascular anastomosis helps prevent anastomotic leakage, especially in patients who have undergone salvage esophagectomy aft...Continue Reading

Citations

Feb 14, 2009·General Thoracic and Cardiovascular Surgery·Yuji Tachimori
Aug 15, 2013·Annals of Surgical Oncology·Hiroshi SaekiYoshihiko Maehara
Apr 9, 2008·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Y K ChaoH P Liu
Nov 26, 2014·Microsurgery·Georgios OrfaniotisHung-Chi Chen
Mar 28, 2006·The Journal of Surgical Research·Seong-Pyo MunYoung-Don Min
Nov 1, 2005·The Journal of Thoracic and Cardiovascular Surgery·Anthony J AsciotiGarrett L Walsh
Mar 23, 2011·The Annals of Thoracic Surgery·Michele DianaMarkus Schäfer
Jul 10, 2007·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·E OkiY Maehara
Mar 7, 2006·Microsurgery·C Kristian EnestvedtBlair A Jobe
Jan 31, 2006·Microsurgery·Gabor PavlovicsPeter Ors Horvath
Apr 19, 2007·Plastic and Reconstructive Surgery·Kazuki UedaShoko Iida
Jun 3, 2017·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·M FujiokaK Taniguchi
Oct 3, 2020·Annals of Gastroenterological Surgery·Hiroshi SaekiKen Shirabe

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