Importance of additional microvascular anastomosis in esophageal reconstruction after salvage esophagectomy

Minoru Sakuraba, Yoshihiro Kimata, Shigeyuki Hishinuma, Mitsuyo Nishimura, Naoto Gotohda, Satoshi Ebihara

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26 Citations (Scopus)

Abstract

Esophageal reconstruction after salvage esophagectomy in patients who have undergone curative-intent chemoradiotherapy for esophageal cancer is associated with a significant risk of perioperative morbidity and mortality. In particular, anastomotic leakage can cause severe and potentially fatal complications, including mediastinitis and pneumonia. The authors performed esophageal reconstruction with a pedicled right colon graft after salvage esophagectomy in eight patients. To decrease the rate of anastomotic leakage, the authors performed an additional microvascular anastomosis at the distal end of the graft. The distal stumps of the ileocolic artery and vein were anastomosed to the cervical vessels. After surgery, aspiration pneumonia and localized wound infection were observed in two patients each, but slight anastomotic leakage was observed in only one patient. Postoperative swallowing function was satisfactory in all patients. Although the incidence of anastomotic leakage is reportedly high, the authors observed anastomotic leakage in only one of eight patients. The authors believe that additional microvascular anastomosis helps prevent anastomotic leakage, especially in patients who have undergone salvage esophagectomy after curative chemoradiotherapy.

Original languageEnglish
Pages (from-to)1934-1939
Number of pages6
JournalPlastic and reconstructive surgery
Volume113
Issue number7
DOIs
Publication statusPublished - Jun 1 2004
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery

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