Reliable preparation of the gastric tube for cervical esophagogastrostomy after esophagectomy for esophageal cancer.
Maintaining sufficient blood flow to the gastric tube is essential to avoid anastomotic leakage after esophageal reconstruction for esophageal cancer. We were able to obtain sufficient blood flow to the tip of the gastric tube by separating the inferior polar branches of the splenic vessels at their origin. By using this procedure, we were able to preserve the junction between the left gastroepiploic vessels and the inferior short gastric vessels without splenectomy. The entire greater omentum also was preserved to use the network between the right and left gastroepiploic vessels. Finally, the anastomotic site was wrapped with the omentum. By using these techniques, the anastomotic site of the gastric tube was well nourished in all patients who underwent esophageal reconstruction for esophageal cancer; anastomotic leakage did not occur.
Matsuda
Takeru
T
Department of Surgery, Kobe Kaisei Hospital, 3-11-15, Shinohara-Kitamachi, Nada-ku, Kobe 657-0078, Japan. t-matsuda@kobe-kaisei.org
Kaneda
Kunihiko
K
Takamatsu
Manabu
M
Takahashi
Masanori
M
Aishin
Keishi
K
Awazu
Masahide
M
Okamoto
Akiko
A
Kawaguchi
Katsunori
K
D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D004944:Esophagoplasty / Q000379:methods*; D004947:Esophagus / Q000098:blood supply / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods; D015203:Reproducibility of Results; D013270:Stomach / Q000098:blood supply / Q000601:surgery; D016896:Treatment Outcome