The influence of anastomotic techniques on postoperative anastomotic complications: Results of the Oesophago-Gastric Anastomosis Audit

To compare the complications associated with mechanical and manual cervical esophagogastric anastomosis following esophagectomy for esophageal cancer.From September, 2004 to June, 2007, 227 patients with middle and upper thoracic esophageal cancer underwent cervical esophagogastric anastomosis after esophagectomy. The patients were randomized into two groups and cervical esophagogastric anastomosis was performed using a stapler (n=102) or manually (n=125). The incidence of postoperative complications and operative time were compared between the two groups.In manual anastomosis group, anastomotic leak and anastomotic stricture occurred in 14.4% (18/125) and 8.8.% (11/125) of the patients, significantly higher than the incidences of 2.9% (3/102) and 3.9% (4/102) in the mechanical anastomosis group (P<0.01). Manual anastomosis required a significantly longer operative time than mechanical anastomosis (52∓12 vs 25∓5 min, P<0.01).The use of circular mechanical stapler in cervical esophagogastric anastomosis is associated with a lower rate of anastomotic leak and a shorter operative time, and is easy to learn and standardize to reduce the complications of the anastomosis.

Esophagectomy

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Evaluation of the Associated Factors with Weight Loss in Esophageal Cancer Patients Undergoing Esophagectomy

Journal of the American Dietetic Association (2011)

Sangmin Youn M. Rha Jin Yang Baek Y. Cho

Esophagectomy

10.1016/j.jada.2011.06.123

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Choice and efficacy evaluation of esophagogastric anastomosis in esophagectomy of esophageal cancer

Zhōnghuá xiāohuà wàikē zázhì/Zhonghua xiaohua waike zazhi (2017)

Yong Yuan

Esophageal reconstruction is of great importance in the practice of esophagectomy, and esophago-gastric anastomosis represents the most essential and key technical aspect of the operation, which largely determined patients′ short-term outcomes. A successful esophageal anastomosis should be no occurrences of postoperative early-stage anastomotic bleeding and leakage and later-stage anastomotic stenosis. The circular stapler, linear cut stapler and hand-sewn anastomosis are the most common anastomotic methods. Hand-sewn anastomosis is the most traditional and classical. Circular stapler has gained significant popularity for its simplicity and convenience. Linear cut stapler used for side-to-side anastomosis has the potential to reduce the risk of postoperative anastomotic stenosis via expanding inner diameter of anastomosis. Every anastomotic method has its advantages and disadvantages, and it cannot completely avoid occurrence of postoperative anastomotic complications. To have a better outcome, both surgeon′s experiences and patient′s individual conditions should be taken into consideration for the choice of anastomotic technique. Key words: Esophageal neoplasms; Esophagectomy; Digestive tract reconstruction; Anastomosis

Esophagectomy

Surgical anastomosis

10.3760/cma.j.issn.1673-9752.2017.05.004

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Supercharged cervical anastomosis for esophagectomy and gastric pull-up

Journal of Thoracic and Cardiovascular Surgery (2020)

Flávio Roberto Takeda Rafael Mamoru Carneiro Tutihashi Francisco Tustumi Rubens Antônio Aissar Sallum Fábio de Freitas Busnardo

Esophagectomy

10.1016/j.jtcvs.2020.06.021

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Effect of en bloc esophagectomy and total meso-esophagectomy on esophageal cancer patients: a systematic review and meta-analysis

AME Medical Journal (2022)

Feng Su Heng Jiao Jun Yin Yong Fang Lijie Tan

Background: Esophagectomy offers the chance of cure for esophageal cancer, however, the optimal circumferential extent of surgery remains uncertain. En bloc esophagectomy (EBE) and total meso-esophagectomy (TME) have yielded inconsistent results. Therefore, the purpose of this study was to evaluate the surgical and oncological effects of EBE and TME on esophageal cancer patients.

Esophagectomy

10.21037/amj-22-38

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Optimum Treatment Strategy for Superficial Esophageal Cancer: Endoscopic Mucosal Resection versus Radical Esophagectomy

World Journal of Surgery (2001)

Hiromasa Fujita Susumu Sueyoshi Hideaki Yamana Koji Shinozaki Uhi Toh

Esophagectomy

Endoscopic mucosal resection

Esophageal disease

Radical surgery

10.1007/s002680020053

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Esophagus (2021)

Yasushi Toh Masaru Morita Manabu Yamamoto Yuichiro Nakashima Masahiko Sugiyama

Esophagectomy

Surgical oncology

10.1007/s10388-021-00874-6

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A Cost and Benefit Study of Esophagectomy for Patients with Esophageal Cancer

Journal of Gastrointestinal Surgery (2009)

Chih‐Cheng Hsieh Ching-Wen Chien

Esophagectomy

10.1007/s11605-009-0965-9

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An appropriate esophagectomy for esophageal cancer: a lack of evidence and a growing disparity between Western and Eastern standards.

Annals of Thoracic and Cardiovascular Surgery (2006)

Tadashi Nishimaki

Definitive chemoradiotherapy has been demonstrated to offer a chance of cure for esophageal cancer as often as a radical esophagectomy. However, it is generally accepted that an esophagectomy remains the mainstay of treatment for patients with resectable esophageal cancer, while chemoradiotherapy is the standard for patients with medically inoperable or surgically unresectable esophageal cancer. The mortality rates and the 5-year survival rates after an esophagectomy were 29% and 4%, respectively, in an early extensive reviews involving 122 English papers on esophageal cancer surgery published between 1960 and 1979. The respective rates have improved to 6.7% and 27.9% in the most recent systematic reviews involving 312 papers published between 1990 and 2000. The overall survival at 5 years was 36.1% after esophagectomy in 11,642 patients between 1988 and 1997 in Japan. A 3-field lymphadenectomy involving the 3 anatomical compartments of the neck, mediastinum, and abdomen was introduced as an important component of a curative esophageal resection in the early 1980s in Japan, and has been reported to be effective for improving not only the staging accuracy, but also the long-term survival in patients with esophageal cancer, with the average 5-year survival rate being 40 to 60%. At present, 63% of all Japanese patients with esophageal cancer undergo an esophagectomy. Of these patients undergoing surgery, a 3-field and a conventional 2-field lymphadenectomy is performed in 35% and 33%, respectively. Alternatively, a transhiatal esophagectomy without a systematic lymphadenectomy has become one of the preferred types of surgery for patients with esophageal cancer in Western countries. An Appropriate Esophagectomy for Esophageal Cancer: A Lack of Evidence and a Growing Disparity between Western and Eastern Standards

Esophagectomy

Lymphadenectomy

Chemoradiotherapy

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Citations (4)