Combined total gastrectomy, total esophagectomy, and D2 lymph node dissection with transverse colonic interposition for adenocarcinoma of the gastroesophageal junction

Butte, Jean M.; Waugh, Enrique; Parada, Hugo; Fuente, Hernán De La

doi:10.1007/s00595-010-4412-z

Cited by 10 publications

(7 citation statements)

References 11 publications

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“…9,22,23 When the tumor invades both esophagus and stomach, esophagectomy with total gastrectomy is an option because it promises both free margins and adequate lymphadenectomy. 24,25 However it is associated with more invasive surgery and morbidity. Our current study should help surgeons to decide whether gastric tube reconstruction or gastrectomy is necessary from the point of view of abdominal lymphadenectomy.…”

Section: Discussionmentioning

confidence: 98%

Distribution of involved abdominal lymph nodes is correlated with the distance from the esophagogastric junction to the distal end of the tumor in Siewert type II tumors

Mine

Kurokawa

Takeuchi

et al. 2015

European Journal of Surgical Oncology (EJSO)

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Section: Discussionmentioning

confidence: 98%

Distribution of involved abdominal lymph nodes is correlated with the distance from the esophagogastric junction to the distal end of the tumor in Siewert type II tumors

Mine

Kurokawa

Takeuchi

et al. 2015

European Journal of Surgical Oncology (EJSO)

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“…Therefore, we performed a total esophagectomy with total gastrectomy if an esophageal macroscopic tumor-free margin of less than 10 cm was determined while in surgery [19][20][21][22] . The aforementioned situation is why patients with EGJ cancer should be prepared for an eventual TEG and colon interposition plus an extended lymph node dissection (D2), due to the frequent lymph node metastasis of groups 1, 2, 3 and 7 of the Japanese classifications [6,7,23] . A second group of patients in whom the indication of TEG is clearer, are those who have a concomitant esophageal and gastric cancer (double cancer).…”

Section: Discussionmentioning

confidence: 99%

“…Considering national series, only series of less than 20 patients with EGJ cancer have been published to date [7][8][9] . The main objectives of this study are: (1) to review the post-operative morbidity and mortality of TEG D2 with interposition of a transverse colon; and (2) to determine the oncological outcomes of TEG D2 with interposition of a transverse colon.…”

Section: Introductionmentioning

confidence: 99%

Total esophagogastrectomy plus extended lymphadenectomy with transverse colon interposition: A treatment for extensive esophagogastric junction cancer

Ceroni¹,

Norero²,

Henríquez³

et al. 2015

WJH

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AIM:To review the post-operative morbidity and mortality of total esophagogastrectomy (TEG) with second barrier lymphadenectomy (D2) with interposition of a transverse colon and to determine the oncological outcomes of TEG D2 with interposition of a transverse colon. METHODS: RESULTS:The series consisted of 21 patients (80.9% men). The median age was 60 years. The 2 main surgical indications were extensive esophagogastric junction cancers (85.7%) and double cancers (14.2%). The mean total surgery time was 405 min (352-465 min). Interposition of a transverse colon through the posterior mediastinum was used for replacement in all cases. Splenectomy was required in 13 patients (61.9%), distal pancreatectomy was required in 2 patients (9.5%) and resection of the left adrenal gland was required in 1 patient (4.7%). No residual cancer surgery was achieved in 75.1% of patients. A total of 71.4% of patients had a postoperative complication. Respiratory complications were the most frequently observed complication. Postoperative mortality was 5.8%. Median follow-up was 13.4 mo. Surgery specific survival at 5 years of follow-up was 32.8%; for patients with curative surgery, it was 39.5% at 5 years.CONCLUSION: TEG for cancer with interposition of a transverse colon is a very complex surgery, and it presents high post-operative morbidity and adequate oncological outcomes. Core tip: Esophagogastric junction cancers are rare tumors that have increased in prevalence in recent decades due to lifestyle changes. Key results of this study are as follows: (1) We describe a treatment for patients with esophago-gastric junction cancer; (2) We show the surgical details in high quality artwork to better represent the surgery; and (3) We show the postoperative and oncological outcomes of this technique.

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“…Twenty studies were retrospective and 3 were prospective. 7,9,10 There were no randomized studies, but 7 studies compared COI results with those following the use of stomach as conduit. The overall study grading was low (grade C).…”

Section: Literature Reviewmentioning

confidence: 99%

Colon Interposition for Esophageal Reconstruction in Cancer Patients

Hangaard

Mortensen

2018

International Surgery

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The aim of this study was to report our experience with colon interposition (COI) and to compare the results with an extensive review of the COI literature. Summary of Background Data: The stomach is the first choice as an esophageal substitute following esophagectomy in cancer patients, while COI is reserved for patients where the stomach is not available or must be included in the resection due to cancer. Methods: We retrospectively reviewed the records of cancer patients undergoing colon interposition from 2006 to 2017. Outcomes were compared with an extensive review of the literature published between 2000 and 2017. Results: A total of 13 patients underwent planned COI. Mortality was zero and overall morbidity was 53%; 4 patients suffered from leakage and 2 patients from strictures. None of the patients suffered from necrosis of the interponat and there was no need for subsequent redundancy operations. The extensive review identified 23 publications. Overall study grading was low (grade C). Only 3 studies were prospective, no randomized studies were found, and many outcomes were poorly defined. The rates for 30-day and in-hospital mortality were 1% and 2%, respectively. Overall morbidity was 43%. The reported number of leakages, strictures, necrosis of the interponat, and redundancy operations varied between 0% and 50%, 0% and 21%, 0% and 9%, and 0% and 2%, respectively. Conclusions: COI is a complex technique that is necessary in a relatively small group of selected patients after esophagectomy for cancer. Prospective and comparative studies with strict outcome definitions, long-term follow up, and patient reported outcome measures are lacking.

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Combined total gastrectomy, total esophagectomy, and D2 lymph node dissection with transverse colonic interposition for adenocarcinoma of the gastroesophageal junction

Cited by 10 publications

References 11 publications

Distribution of involved abdominal lymph nodes is correlated with the distance from the esophagogastric junction to the distal end of the tumor in Siewert type II tumors

Distribution of involved abdominal lymph nodes is correlated with the distance from the esophagogastric junction to the distal end of the tumor in Siewert type II tumors

Total esophagogastrectomy plus extended lymphadenectomy with transverse colon interposition: A treatment for extensive esophagogastric junction cancer

Colon Interposition for Esophageal Reconstruction in Cancer Patients

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