[Esophageal resection with fundus rotation gastroplasty].
Esophageal resection with fundus rotation gastroplasty. Anastomotic failure after esophageal resection remains a surgical problem with high clinical relevance. Anastomotic failure can be attributed to tension at the anastomosis especially in cervical anastomoses, as well as a perfusion deficit due to resection of the arterial arcade along the gastric lesser curvature. We attributed the anatomical deficiencies of conventional gastroplasties by developing a technique, that utilizes the whole gastric fundus and maintains the arterial arcade along the gastric lesser curvature: fundus rotation gastroplasty. Experimentally those tubes are 20 % longer than conventional tubes according to Kirschner/Akiyama and twice as good perfused. Clinically low failure rates of 7 % for cervical and thoracic anastomoses are achieved.
Schilling
M K
MK
Klinik für Viszerale- und Transplantationschirurgie, Inselspital, Universität Bern Switzerland. martin.schilling@insel.ch
Maurer
C A
CA
Kollmar
O
O
Büchler
M W
MW
D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D005748:Gastric Fundus / Q000601:surgery*; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies