Reconstruction Using a Pedunculated Gastric Tube with Duodenal Transection After Esophagectomy and Pharyngolaryngectomy

Annals of Surgical Oncology
N YoshidaHideo Baba

Abstract

Gastric conduit ischemia is sometimes correlated with anastomosis-related morbidities after esophagectomy and pharyngolaryngectomy.1 (-) 5 A lack of connection between the right and left gastroepiploic vessels and intraoperative injury to these vessels could cause conduit ischemia. In addition, tensioned anastomosis due to a short gastric tube also could contribute to anastomotic leaks. This report introduces a reconstruction technique using a pedunculated gastric tube with duodenal transection for these cases. Creation of a gastric tube in the greater curvature of the stomach is performed with linear staplers. Only the right gastroepiploic vessels are preserved. The gastric tube is finally fashioned with a width of approximately 4 cm. The peripheral right gastroepiploic vessels to the pylorus are sacrificed. After the bulbs are transected, a pedunculated gastric tube is moved, with confirmation whether it has sufficient length for anastomosis in the neck. After the anal side of the gastric tube is transected, Roux-en-Y gastrointestinal anastomosis is performed. Finally, esophagogastric or pharyngogastric anastomosis is performed. Between November 2011 and September 2014, 18 patients underwent the reported reconstruction techni...Continue Reading

References

Jun 1, 1995·American Journal of Surgery·J D Urschel
May 16, 2006·Thoracic Surgery Clinics·John D Mitchell
May 30, 2009·Journal of the American College of Surgeons·Arzu OezcelikTom R DeMeester
Jul 24, 2012·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·A K YetasookM B Ujiki

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