Salvage reconstruction of the oesophagus: a retrospective study of 15 cases

Oki, Masanao; Asato, Hirotaka; Suzuki, Yasutoshi; Umekawa, Kohei; Takushima, Akihiko; Okazaki, Mutsumi; Harii, Kiyonori

doi:10.1016/j.bjps.2009.01.038

Cited by 15 publications

(8 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Salvage reconstruction, mainly after gastric tube necrosis, accounted for most of colon interposition procedures in the present series. The incidence of graft necrosis after gastric pull‐up for cancer is around 2% ; however, reports in the literature are scarce and to our knowledge this is the largest published series of salvage colon interpositions for cancer. High mortality rates of gastric conduit necrosis, cancer recurrence, and lack of expertise with difficult colon interposition procedures are possible explanations.…”

Section: Discussionmentioning

confidence: 98%

Esophageal reconstruction by colon interposition after esophagectomy for cancer analysis of current indications, operative outcomes, and long‐term survival

Reslinger

Tranchart

D’Annunzio

et al. 2015

Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 98%

Esophageal reconstruction by colon interposition after esophagectomy for cancer analysis of current indications, operative outcomes, and long‐term survival

Reslinger

Tranchart

D’Annunzio

et al. 2015

Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

“…As for other visceral flaps, colon interposition has been used to salvage failed jejunal transfer. 12 , 13 However, colon interposition is widely considered to be a method of last resort, associated with high morbidity and mortality. 19 Sacak et al 20 succeeded in the salvage of complicated gastric pull-up procedure using colon interposition for esophageal reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Salvage Treatment of Failed Free Jejunal Flap Transfer: Our Experiences and Literature Review

Kubo

Seike

Kiya

et al. 2018

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background:Although there have been many reports on the success of free jejunal flap transfer for pharyngoesophageal reconstruction, reports on salvage procedures for failed transfers remain sparse. In this report, we retrospectively reviewed our salvage procedures for failed jejunal transfers and previous articles describing salvage treatment in failed jejunal flap cases.Methods:This report includes 6 cases of failed jejunal flap transfer, leading to necessary salvage surgery. We reviewed all cases to examine salvage procedures and early postoperative complications such as fistula formation. We also assessed postoperative late complications and swallowing function during long-term follow-up. A review of the literature was performed via PubMed.Results:Rejejunal transfer was performed successfully in 3 of 6 cases. Gastric pull-up reconstruction was adopted in 2 cases. In 1 case, an external stoma was created because of the patient’s poor medical condition. All 3 cases of rejejunal transfer and 1 gastric pull-up case recovered to resuming a normal diet. However, 1 gastric pull-up case required supplemental feeding with a jejunostomy tube. We reviewed 6 articles describing salvage treatment in failed jejunal flap cases.Conclusion:When free jejunal transfer fails, rejejunal transfer is optimal. However, in cases that lack suitable recipient vessels or have infection, a second jejunal transfer should not be considered. In such cases, gastric pull-up or colon interposition may be an alternative because they do not require vascular anastomosis. Pedicled pectoralis major flap is also an alternative, although the risk of salivary fistulas is very high.

show abstract

“…Reports of two-stage esophageal salvage reconstruction surgery [ 1 , 5 , 6 ] show that the reconstruction surgery step is generally performed after a relatively long time, 1–6 months, after debridement. This delay relates to the inflammation remaining after debridement, which must subside before reconstruction can be performed [ 1 , 5 , 6 ].The advantage of this approach is its safety in terms of infection. However, its disadvantage is that the recipient vessels needed for the reconstruction may be damaged by the scarring arising from the debridement and the prolonged inflammation, which complicates recipient vessel selection.…”

Section: Discussionmentioning

confidence: 99%

“…The first step was the removal of necrotic tissue and the second step was reconstruction. The interval between these two steps ranged from 1 to 6 months [ 1 ]. The outcomes of this treatment are acceptable and patients can start oral ingestion on average 14 days after the reconstruction step.…”

Section: Introductionmentioning

confidence: 99%

Immediate Free Jejunum Transfer for Salvage Surgery of Gastric Tube Necrosis

Umezawa

Matsutani

Ogawa

2014

Case Reports in Gastrointestinal Medicine

View full text Add to dashboard Cite

Gastric tube necrosis after esophagus cancer surgery is a rare but critical situation. Salvage reconstruction of the esophagus remains a challenging procedure for head and neck surgeons. Historically, surgeons have employed a two-stage salvage surgery consisting of debridement followed by reconstruction. While this procedure generates good results, the time to restart oral alimentation is long. The present report describes the case of a 62-year-old male who developed gastric tube necrosis 3 days after undergoing surgery for thoracic-cervical esophageal cancer and immediate reconstruction with the retrosternal gastric pullup technique. He was treated with debridement and simultaneous free jejunum transfer 4 days after the primary surgery. He was able to restart oral alimentation 10 days after the salvage surgery. This rapid return to oral alimentation is a major advantage of the one-stage immediate esophagus salvage reconstruction. Another advantage is the ease of the reconstructive procedure: the absence of scarring and prolonged inflammation, which are disadvantages of the two-stage procedure, meant that recipient vessel selection and anastomosis were uncomplicated. The one-step procedure may be particularly useful in cases where the inflammation is discovered early.

show abstract

Salvage reconstruction of the oesophagus: a retrospective study of 15 cases

Cited by 15 publications

References 14 publications

Esophageal reconstruction by colon interposition after esophagectomy for cancer analysis of current indications, operative outcomes, and long‐term survival

Esophageal reconstruction by colon interposition after esophagectomy for cancer analysis of current indications, operative outcomes, and long‐term survival

Salvage Treatment of Failed Free Jejunal Flap Transfer: Our Experiences and Literature Review

Immediate Free Jejunum Transfer for Salvage Surgery of Gastric Tube Necrosis

Contact Info

Product

Resources

About