Early stage results after oesophageal resection for malignancy – colon interposition vs. gastric pull-up

Kolh, Philippe; Honoré, Pierre; Degauque, C; Gielen, Jean-Louis; Gérard, Paul; Jacquet, Nicolas

doi:10.1016/s1010-7940(00)00524-8

Cited by 42 publications

(35 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our postsurgical complication rates of graft necrosis (6.2%), anastomotic leak (12.5%), and anastomotic stricture (18.7%) were similar to those previously reported (Table 3) (1,3,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) Of these studies, five (including ours) routinely used preoperative angiography in all or a defined select group of patients, two did not use routine preoperative angiography, and six did not report whether preoperative angiography was used. The rate of graft necrosis ranged from 3% to 5% in those who did not routinely perform preoperative angiography; 3% to 9.6% in those who did perform angiography in all or a predefined select group of patients; and 0% to 9% in those who did not report if they did or did not perform angiography.…”

Section: Discussionsupporting

confidence: 87%

The role of preoperative angiogram in colon interposition surgery

McDermott

Deipolyi

Walker

et al. 2011

Diagn Interv Radiol

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 87%

The role of preoperative angiogram in colon interposition surgery

McDermott

Deipolyi

Walker

et al. 2011

Diagn Interv Radiol

View full text Add to dashboard Cite

“…From 1982 to 1990, 75 (15.9%) of 472 patients in the stomach group died in the hospital, compared with 27 (5.5%) of 487 during 1991 to 2000. 17 The respective figures for the colon group were 7 (24%) of 29 and 0 of 13 patients. In the present series, there was no mortality in colon group but 4 patients (12.5%) died in the hospital in the postoperative period.…”

Section: Discussionmentioning

confidence: 93%

“…when the disease is malignancy, then because the life expectancy is short, we prefer to use stomach as a conduit. 13,17 It has been our practice to use the colon for reconstruction only in patients whose stomach was diseased. In the present series jejunum was not used in any patient.…”

Section: Discussionmentioning

confidence: 99%

Conduits for esophageal replacement: alternatives

2017

View full text Add to dashboard Cite

Background: Native esophageal replacement after esophageal resection is a problem that has challenged the surgeons over a century. Conduit must be long enough to bridge between cervical esophagus and abdomen. It must have reliable vascular supply, so that it can perform its function of deglutition. Stomach, colon and jejunum all these are used since long. However, there are times when the stomach is unavailable for use as a conduit. It is in these instances that an esophageal surgeon must have an alternative conduit in their armamentarium. Present study is aimed to discuss technical aspects of stomach, colonic, interposition in 32 cases of benign and malignant pathology, we review recent literature with a focus on outcomes, advantages and disadvantages of all options.Methods: A retrospective study of 32 cases between 2009 to 2016 at teaching institute in central India. 32 cases of benign and malignant esophageal disease needing esophageal resection and replacement. The record of each patient was reviewed for age, gender, indication for esophageal resection, type of operation, indication for selection of conduit, morbidity and mortality. The patient’s gastrointestinal symptoms were graded as excellent, good, fair or poor. Survival was estimated by the Kaplan-Meier method using the date of operation as the starting point.Results: Study includes 24 males and 8 females, 25 cases cancer esophagus with 6 patients caustic stricture, 1 patient had radiation stricture. Gastric conduit was used in 29 patients while 3 patients had colonic interposition. No complications noted in colonic group, while cervical anastomotic leak along with cardiovascular and respiratory complications noted in 6 patients. Gastric replacement was less time consuming than colonic interposition. There was hospital mortality of 4 patients. There is no difference in survival of these patients whether you use gastric or colonic conduit.Conclusions: Clinical decision making in the treatment of esophageal cancer consists of balancing the risks of a particular treatment against potential benefits gained in survival and quality of life. The choice of conduit for reconstruction may have significant impact on the quality of life. Stomach is the most commonly used organ for replacement but when it is not available then colon can safely be used as an esophageal replacement.

show abstract

“…[6][7][8] In oesophageal reconstruction, six to 12 months is the recommended waiting period, from the time of caustic ingestion until surgery to allow complete scarring of the oesophagus. 2,9 It is essential that adequate nutrition be maintained during this period to ensure optimal postoperative wound healing, and a PEJ is invariably placed preoperatively and maintained postoperatively until the patient is able to consume adequate nutrition orally without complications.…”

Section: Anthropometrymentioning

confidence: 99%