The Role of Esophagogastric Anastomotic Technique in Decreasing Benign Stricture Formation in the Surgery of Esophageal Carcinoma

Sokouti, Mohsen; Golzari, Samad Ej; Pezeshkian, Masoud; Farahnak, Mohammad-Reza

doi:10.5681/jcvtr.2013.003

Cited by 2 publications

(2 citation statements)

References 38 publications

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“…The standard operation usually started with exploration and mobilisation of oesophageal lesion ( 5 , 6 ). Gastric conduit reconstruction consisted of creating a 4–6 cm wide gastric tube with multiple firings of a linear stapler [Proximate Linear Cutter-TLC75, Johnson & Johnson Medical (China) Co. Ltd., Shanghai, China] along the greater curvature.…”

Section: Methodsmentioning

confidence: 99%

Risk factors for benign anastomotic stricture post-oesophagectomy: single-centre analysis of 702 oesophagectomies with squamous cell carcinoma

Gu¹,

Yang²,

Shang³

et al. 2019

Transl. Cancer Res

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Background Benign stricture formation after oesophagectomy makes a considerable impact on postoperative recovery, nutritional status and quality of life. Our aim was to investigate the incidence and risk factors for benign anastomotic stenosis post-oesophagectomy in a large series of patients. Methods We conducted a retrospective study of all patients undergoing oesophagectomy of oesophageal squamous cell carcinoma (ESCC) in our department from August 2012 to May 2013. Anastomotic stricture was identified clinically and radiologically. A total of 14 clinicopathological variables were assessed by univariate and multivariate logistic regression analyses. Results The study included 702 patients, and anastomotic stricture occurred in 62 patients (8.8%), which was significantly higher after cervical (20.8%) anastomosis than below (7.4%) or above (6.6%) aortic arch anastomosis. The anastomotic stricture rate was 31.8% in single-layer hand sewn (s-HS) anastomosis, 11.7% in circular stapled (CS) anastomosis, 10.4% in double-layer hand-sewn (d-HS) anastomosis and 1.9% in semi-mechanical (SM) anastomosis. The univariate analysis found that hypertension, surgical approach, anastomotic technique, anastomosis site, total number of removed lymph node and anastomotic leakage were associated with anastomotic stricture rate (P<0.05). Age, gender, body mass index (BMI), history of smoking or diabetes, the length of tumour, pT stage, pN stage and historical grading showed no statistically significant difference in the incidence of benign stenosis (P>0.05). On multivariate analysis, anastomosis site (P=0.006) and anastomotic technique (P<0.001) were independently associated with stricture risk. Conclusions Our study highlighted that patients with ESCC undergoing cervical anastomosis should be cautiously monitored postoperatively as a result of relative high stricture rate. SM technique is the preferred method of oesophago-gastric anastomosis due to a decreased stricture formation compared with other techniques.

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Section: Methodsmentioning

confidence: 99%

Risk factors for benign anastomotic stricture post-oesophagectomy: single-centre analysis of 702 oesophagectomies with squamous cell carcinoma

Gu¹,

Yang²,

Shang³

et al. 2019

Transl. Cancer Res

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show abstract

“…Other contemporary reports show CEGA leak rates of 12% to 30%, which is higher than generally encountered with an intrathoracic anastomosis. 4 , 5 , 6 , 7 , 8 , 9 , 10 Although CEGA leaks are usually easily managed with wound packing, leaks often result in chronic strictures—a functional failure for an operation intended to provide comfortable swallowing. Whereas the CEGA is often considered the easy portion of a THE procedure, the 15 to 20 minutes needed are an important part of the operation and have the greatest long-term influence on comfortable swallowing.…”

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confidence: 99%

Multi-institutional beta testing of a novel cervical esophagogastric anastomosis simulator

Lin,

Rooney,

Yang

et al. 2024

JTCVS Techniques

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The Role of Esophagogastric Anastomotic Technique in Decreasing Benign Stricture Formation in the Surgery of Esophageal Carcinoma

Cited by 2 publications

References 38 publications

Risk factors for benign anastomotic stricture post-oesophagectomy: single-centre analysis of 702 oesophagectomies with squamous cell carcinoma

Risk factors for benign anastomotic stricture post-oesophagectomy: single-centre analysis of 702 oesophagectomies with squamous cell carcinoma

Multi-institutional beta testing of a novel cervical esophagogastric anastomosis simulator

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