“Supercharged” Isoperistaltic Colon Interposition for Long-Segment Esophageal Reconstruction

Kesler, Kenneth A.; Pillai, Saila T.; Birdas, Thomas J.; Rieger, Karen M.; Okereke, Ikenna; Ceppa, DuyKhanh P.; Socas, Juan; Starnes, Sandra L.

doi:10.1016/j.athoracsur.2013.01.006

Cited by 41 publications

(30 citation statements)

References 13 publications

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“…Gastric pull-up for esophageal reconstruction after cervical and thoracic THE can be used, but we preferred the long colonic graft in order to reduce tension on the cervical anastomosis at the hypopharynx level and thus decrease the risk of anastomotic fistula (7). We performed pyloroplasty for duodenal drainage after vagal trunk resection, although some authors showed that this is not mandatory if the endoscopic method is used in case of postoperative post-vagotomy gastroparesis (6).…”

Section: Discussionmentioning

confidence: 99%

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Simultaneous Total Esophagectomy and Anterior Mediastinal Tracheostomy for Recurrent Laryngeal Cancer Extended to the Superior Mediastinum

Fodor¹,

Cosgarea²,

Fodor³

2017

chr

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RezumatCancerul laringian recidivat are incidenţã de 25-50% şi ratã de supravieţuire la 5 ani de 23-35%. Chirurgia este cel mai bun tratament pentru a realiza controlul local a recidivei tumorale. În acest articol, se prezintã strategia chirurgicalã în cazul unui pacient cu antecedente de laringectomie radical modificatã pentru cancer laringian şi cu recidivã tumoralã la nivelul traheostomiei extinsã la traheea toracicã şi la esofag. Timpul chirurgical de rezecţie a inclus manubriul sternal, traheea toracicã superioarã, esofagul în totalitate şi limfoganglionii mediastinali superiori. Timpul chirurgical de reconstrucţie a inclus traheostomia mediastinalã anterioarã şi esofagoplastia cu grefon colic pediculat simultan cu lamboul de pectoral mare pentru acoperirea defectului sternal.Cuvinte cheie: cancer laringian recidivat, traheostomia mediastinalã anterioarã, esofagoplastia, grefon colic Abstract Recurrent laryngeal cancer has an incidence of 25-50% and a 23-35% fiveyear survival rate. Surgery is the best treatment in order to control local recurrence. Herein, we present our surgical strategy for a patient with a history of modified radical laryngectomy for laryngeal cancer and with recurrent tumor at the cervical tracheostomy site extended to the thoracic trachea and esophagus. The wide resection included the sternal manubrium, the upper thoracic trachea, the entire esophagus and the upper mediastinal lymph nodes. The reconstruction included anterior mediastinal tracheostomy and esophagoplasty with pedicled colonic graft simultaneously with pectoralis major flap for covering the sternal defect.

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Section: Discussionmentioning

confidence: 99%

“…Esophagectomy without thoracotomy reduced postoperative morbidity and mortality rates, thus proving to be a good surgical method. The reconstruction of the alimentary tract can be done with colonic, stomach and jejunal grafts (6,7).…”

Section: Introductionmentioning

confidence: 99%

Simultaneous Total Esophagectomy and Anterior Mediastinal Tracheostomy for Recurrent Laryngeal Cancer Extended to the Superior Mediastinum

Fodor¹,

Cosgarea²,

Fodor³

2017

chr

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“…The "supercharged" ileocoloplasty is considered to be a last but viable solution in cases in which the risk of substitute ischemia is high (20).…”

Section: Discussionmentioning

confidence: 99%

Outcomes after Transhiatal Esophagectomies in an Eastern-European Low-Volume Center

et al. 2015

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Surgery alone or associated with radio-chemo-therapy (RCT) as a multimodal approach remains the main method of treatment for resectable esophageal cancer (1, 2). Right transthoracic esophagectomy (Ivor Lewis technique) and transhiatal esophagectomy (Orringer procedure) are the most widely used standard techniques; the superiority of either of these methods is still a subject of intense controversy (2, 3). There is increasing evidence that among factors which influence the postoperative results, including long-term survival, in patients who undergo complex oncological resections such as esophagectomy, the hospital-volume and surgeon-volume play an important role (4-6). Background:The present study proposes to analyze the results obtained after transhiatal esophagectomies (THE), from the perspective of an Eastern European surgical center with low esophageal resection volume (LV). Aims: Our analysis, which to the authors' knowledge is the first of its kind in Romania, has the purpose of comparing our results with those obtained in higher or similar volume centers, in order to derive conclusions regarding the quality of therapeutic management for patients diagnosed with esophageal cancer in Romania. Study Design: Retrospective observational study. Methods: In total, 70 patients were included, in whom THE was performed during the period 1997-2013 by six senior surgeons. The majority of our patients had esophageal cancers (n=66; 94.3%); we also performed 4 THE procedures for benign conditions (n=3; 4.27%) and esophageal perforation (n=1; 1.42%). Results: The majority of cancer-group patients had T3/ N+ tumors. The nodal involvement in the T2, T3 and T4 categories was 9.9%, 21.6% and 35.1%, respectively.Complications were identified in 45 patients (68.2%), with the majority being represented by pulmonary complications (16 patients; 24.3%) and cervical leaks (15 cases; 22.7%). In-hospital mortality was 9.09%. We found a one-year overall survival rate of 58.7% (95%CI: 51.7-65.7%), 27.2% at 2 years (95%CI: 21.2-36.2%) and 10.5% at 3 years (95%CI: 6.5-14.5%). The median survival rate was estimated to be 16 months. Conclusion: Morbidity and in-hospital mortality after THE was performed in low-volume centers, despite being significantly higher than reported in HV centers, could be kept at reasonable rates. In our opinion, the measures which have the potential to raise the standard of care for patients diagnosed with esophageal cancer in Romania are represented by the standardization of therapeutic and diagnostic protocols for esophageal cancer and the centralization of these major oncologic interventions in surgical excellence centers.

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“…Esta estenosis, de no ser tratada, puede llevar a neumonitis recurrentes por aspiración [10][11][12][13][14][15][16] . Las complicaciones posteriores a la interposición de colon pueden ser agudas o crónicas, con frecuencia devastadoras [17][18][19] . Se necesitan estrategias creativas para solucionar esas complicaciones [16][17][18][19][20] .…”

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“…Las complicaciones posteriores a la interposición de colon pueden ser agudas o crónicas, con frecuencia devastadoras [17][18][19] . Se necesitan estrategias creativas para solucionar esas complicaciones [16][17][18][19][20] . En un estudio de de Delva y cols.…”

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Reconstitución De Tránsito Esofágico Con Interposición De Colon Derecho

et al. 2015

Rev Chil Cir

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esophageal reconstruction using right colon interposition background: Esophageal replacement therapy is indicated for benign and malignant esophageal lesions and can be performed using stomach, jejunum or colon. aim: To report the experience using right colon interposition for esophageal replacement. material and methods: Review of medical records of 41 patients aged 17 to 73 years (29 males), subjected to right colon interposition in the last 20 years. Indications, complications, mortality and long term results were recorded. results: Forty nine percent of patients had a malignant esophageal lesion. Esophagectomy was performed using a transhiatal route or thoracotomy in 44 and 30% of patients, respectively. Retroesternal ascension was the most common route used in 88% of patients. The most common surgical complication was cervical fistula in 29% of patients, followed by fistula of the anastomosis between colon and jejunum in 7% of patients. Pneumonia was the most common medical complication. Postoperative mortality was 7%. conclusions: The mortality in this series of patients is similar to that reported elsewhere.

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“Supercharged” Isoperistaltic Colon Interposition for Long-Segment Esophageal Reconstruction

Cited by 41 publications

References 13 publications

Simultaneous Total Esophagectomy and Anterior Mediastinal Tracheostomy for Recurrent Laryngeal Cancer Extended to the Superior Mediastinum

Simultaneous Total Esophagectomy and Anterior Mediastinal Tracheostomy for Recurrent Laryngeal Cancer Extended to the Superior Mediastinum

Outcomes after Transhiatal Esophagectomies in an Eastern-European Low-Volume Center

Reconstitución De Tránsito Esofágico Con Interposición De Colon Derecho

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