Technique for isoperistaltic gastric tube for esophageal bypass.
There has not been described a uniformly successful method for palliation of inoperable carcinoma of the esophagus, especially malignant tracheoesophageal fistula. A gastric tube formed from the greater curvature of the stomach is being evaluated for these patients. The blood supply is based on the right gastroepiploic vessels. Using a stapler, one can form a gastric tube sufficiently long to reach the hypopharynx. Placed substernally, anastomosis to the cervical esophagus is performed. In 30 patients postoperative mortality has been 13%. No tube necrosis has occurred, but anastomotic leakage has been a problem. In those patients who had esophageal bypass for palliation and were discharged from the hospital, swallowing function has been satisfactory and the average survival has been 5.2 months.
D004937:Esophageal Fistula / Q000601:surgery; D004938:Esophageal Neoplasms / Q000601:surgery; D004940:Esophageal Stenosis / Q000601:surgery; D004947:Esophagus / Q000601:surgery*; D005069:Evaluation Studies as Topic; D005769:Gastrointestinal Motility; D006801:Humans; D007440:Intubation / Q000379:methods*; D008722:Methods; D010528:Peristalsis; D011183:Postoperative Complications; D013270:Stomach / Q000098:blood supply / Q000601:surgery*