title: Antethoracic pedicled jejunum reconstruction with the supercharge technique for esophageal cancer.
abstract: BACKGROUND
  Gastric tube is the first choice as an esophageal substitute for reconstruction after esophagectomy. Colon or jejunum is selected for patients in whom stomach cannot be used. Colon interposition is reported to have a high incidence of anastomotic leakage and mortality. For safer surgical treatment, the authors adopted supercharged pedicle jejunum reconstruction as the operation of choice in patients with esophageal cancer who had no stomach to use as an esophageal substitute. The aim of this study was to review our experience with this technique.
  
  
  METHODS
  From 2003 to 2009, esophagectomy and antethoracic pedicled jejunum reconstruction with the supercharge technique was performed in 27 patients with esophageal cancer at the Department of Gastroenterological Surgery (Surgery II), Nagoya University Hospital. Medical records of these 27 patients were retrospectively reviewed to determine demographic data, diagnosis, functional results, and perioperative course.
  
  
  RESULTS
  Median operating time, blood loss, hospital stay, and duration of enteral feeding were 636 min (range 454-856 min), 580 ml (range 208-1959 ml), 27 days (range 16-72 days), and 80 days (range 26-1740 days), respectively. There were no in-hospital deaths. Anastomotic leakage occurred in two patients and was successfully managed conservatively. In 2 of 27 patients, the pedicled jejunum was of insufficient length, and additional procedures were needed to complete the anastomosis.
  
  
  CONCLUSIONS
  Although antethoracic pedicled jejunum reconstruction with the supercharge technique is technically demanding, it is a reliable technique and contributes to successful reconstruction after esophagectomy for patients in whom stomach is not available for reconstruction.
authors.affiliation: Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan. iwt-nk@med.nagoya-u.ac.jp
authors.forename: Naoki
authors.initials: N
authors.lastname: Iwata
authors.forename: Masahiko
authors.initials: M
authors.lastname: Koike
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Kamei
authors.forename: Chie
authors.initials: C
authors.lastname: Tanaka
authors.forename: Norifumi
authors.initials: N
authors.lastname: Ohashi
authors.forename: Goro
authors.initials: G
authors.lastname: Nakayama
authors.forename: Shuji
authors.initials: S
authors.lastname: Nomoto
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Fujii
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sugimoto
authors.forename: Michitaka
authors.initials: M
authors.lastname: Fujiwara
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kodera
mesh_terms: D000368:Aged; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D007583:Jejunum / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013524:Surgical Flaps