Single-layered cervical esophageal anastomoses: A prospective study of two suturing techniques

Bardini, Romeo; Bonavina, Luigi; Asolati, Michele; Ruol, Alberto; Castoro, Carlo; Tiso, E

doi:10.1016/0003-4975(94)90461-8

Cited by 62 publications

(45 citation statements)

References 15 publications

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“…A continuous suture provides an enhanced air and watertight seal [28,29] . As our study shows, a continuous suture reduces anastomosis time [30,31] . A continuous suture is technically easier [30,31] and costs less [31,32] .…”

Section: Discussionmentioning

confidence: 87%

“…As our study shows, a continuous suture reduces anastomosis time [30,31] . A continuous suture is technically easier [30,31] and costs less [31,32] . For continuous sutures, we use one polypropylene (Prolene * , Ethicon, Somerville, NJ) thread, and the thread costs 5.7 dollars.…”

Section: Discussionmentioning

confidence: 87%

“…Theoretically, the continuous suture method has many advantages over the interrupted suture method [27][28][29][30][31][32] . First of all, a more even distribution of tension is possible in the continuous suture between the pancreatic parenchyma and jejunum [27] .…”

Section: Discussionmentioning

confidence: 99%

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Pancreatic fistula after pancreaticoduodenectomy: A comparison between the two pancreaticojejunostomy methods for approximating the pancreatic parenchyma to the jejunal seromuscular layer: Interrupted vs continuous stitches

Lee

Yang

Jang³

et al. 2007

WJG

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AIM:The purpose of this study is to find a better operative technique by comparing interrupted stitches with continuous stitches for the outer layer of the pancreaticojejunostomy, i.e., the stitches between the stump parenchyma of the pancreas and the jejunal seromuscular layer, and other risk factors for the incidence of pancreatic leakage. METHODS:During the period January 1997 to October 2004, 133 patients have undergone the end-to-side and duct-to-mucosa pancreaticojejunostomy reconstruction after pancreaticoduodenectomy with interrupted suture for outer layer of the pancreaticojejunostomy and 170 patients with a continuous suture at our institution by one surgeon. RESULTS:There were no significant differences between the two groups in the diagnosis, texture of the pancreas, use of octreotide and pathologic stage. Pancreatic fistula occurred in 14 patients (11%) among the interrupted suture cases and in 10 (6%) among the continuous suture cases (P = 0.102). Major pancreatic leakage developed in three interrupted suture patients (2%) and zero continuous suture patients (P = 0.026). In multivariate analysis, soft pancreatic consistency (odds ratio, 5.5; 95% confidence interval 2.3-13.1) and common bile duct cancer (odds ratio, 3.7; 95% CI 1.6-8.5) were predictive of pancreatic leakage. CONCLUSION:Pancreatic texture and pathology are the most important factors in determining the fate of pancreaticojejunal anastomosis and our continuous suture method was performed with significantly decreased occurrence of major pancreatic fistula. In conclusion, the continuous suture method is more feasible and safer in performing duct-to-mucosa pancreaticojejunostomy.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 87%

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Pancreatic fistula after pancreaticoduodenectomy: A comparison between the two pancreaticojejunostomy methods for approximating the pancreatic parenchyma to the jejunal seromuscular layer: Interrupted vs continuous stitches

Lee

Yang

Jang³

et al. 2007

WJG

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“…As mentioned, incidence of anastomosis in the neck is higher than the thorax (27,28). In fact, there is no connection when using stapler instead of anastomosis by hand or there is the least degree of connection; thus, surgeons prefer anastomosis by hand to mechanical techniques (stapler) (29)(30)(31). However, the type of anastomosis is known as the most important factor for postoperative benign strictures (32).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Early and Late Complications in Three Esophagectomy Techniques

Mousavi¹,

Akbari²

2017

Int J Cancer Manag

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Background: Due to the high prevalence and mortality rates of esophageal cancer in some parts of the world and considering that in most patients, symptoms occur when cancer is advanced, this study aimed to compare early and late complications in three esophagectomy techniques for treatment of esophageal cancer. Methods: The present study was a descriptive research on 316 patients with esophageal cancer referring to Shohada Tajrish hospital, Tehran. The results were recorded in the research forms consisting of individual characteristics, symptoms and reasons for referring to the hospital. Findings were extracted after classification and evaluated using descriptive statistics. Results: Among 316 patients studied, 190 patients (60%) were male and 126 (40%) were female. The highest prevalence was between 40 and 60 years old. The most significant reason for referring to the hospital was dysphagia and weight loss. Among 260 patients, 72 patients (27.7%) underwent surgery by transthoracic (Ivor Lewis type) approach, 76 patients (29.2%) underwent surgery by threeincision approach (Mc Keown procedure), and 112 patients (43%) underwent surgery by Trans-Hiatal (Oringer). A total of 36 deaths occurred. 22 deaths occurred using Ivor-Lewis (61%), 10 deaths occurred using Mc Keown (27.7%) and 4 deaths occurred after Oringer (11.1%). In terms of prevalence of complications, the most common early complication was pleural effusion (11%) and the most common late complication was anastomotic stricture (17.8%). Conclusions:Complications occurred in all three surgeries. The most complications occurred using transthoracic (Ivor Lewis type) approach and the least complications occurred using Trans-Hiatal (Oringer).

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“…The two-layer simple interrupted closure results in greater wound strength, good tissue apposition, and improved healing compared with the singlelayer simple interrupted closure (Oakes et al, 1993;Bardini et al, 1994). The operation time of the continuous suture pattern is faster than the interrupted suture pattern.…”

Section: Discussionmentioning

confidence: 88%

Reconstruction of the oesophagus using pedicle diaphragm and omentum flaps in a dog: a case report

Lee¹,

Alam²,

Kim³

2008

Vet. Med. - Czech

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A two-years-old, intact female, Shih-Tzu dog weighing 5 kg was presented to the Chonbuk Animal Medical Centre, College of Veterinary Medicine, Chonbuk National University, with the history of bone ingestion before two days. The survey radiographs of the thorax revealed a bone at the caudal thoracic oesophagus. An oesophagram was performed which did not reveal any oesophageal leakage or perforation. The left caudolateral thoracotomy was performed and the caudal oesophagus was found partially necrosed, friable and inflamed. The necrosed, friable part was removed and the oesophageal defect was reconstructed using a full-thickness muscle flap collected from the diaphragm. A part of the omentum was mobilized from the abdomen and sutured over the reconstructed site of the oesophagus to aid healing. Oesophagoscopy after nine days postoperatively showed a good adhesion of the diaphragm flap. The patient showed normal activity after 12 days and no complications were observed during a one-year follow up period. The pedicle flap collected from the left hemidiaphragm in addition to the omentum flap can be successfully used to reconstruct the circumferential oesophageal defect.

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Single-layered cervical esophageal anastomoses: A prospective study of two suturing techniques

Cited by 62 publications

References 15 publications

Pancreatic fistula after pancreaticoduodenectomy: A comparison between the two pancreaticojejunostomy methods for approximating the pancreatic parenchyma to the jejunal seromuscular layer: Interrupted vs continuous stitches

Pancreatic fistula after pancreaticoduodenectomy: A comparison between the two pancreaticojejunostomy methods for approximating the pancreatic parenchyma to the jejunal seromuscular layer: Interrupted vs continuous stitches

Comparison of Early and Late Complications in Three Esophagectomy Techniques

Reconstruction of the oesophagus using pedicle diaphragm and omentum flaps in a dog: a case report

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