Use of oesophageal flap valvuloplasty and wrapping suturing technique in preventing postoperative complications after oesophagectomy for oesophageal cancer.
BACKGROUND
Esophagogastrostomy for oesophageal cancer is the standard surgical treatment. However, traditional techniques have been associated with high frequency of anastomotic complications. The purpose of this study is to clarify the superiority of the oesophageal flap valvuloplasty and wrapping suturing technique in preventing postoperative complications after oesophagectomy for oesophageal cancer.


METHODS
A prospective, randomised study was performed on 394 patients treated for esophageal cancer between January 2006 and December 2010. The trial registry number is ChiCTR-TRC-13003817 in the Chinese Clinical Trial Registry.


RESULTS
Anastomotic leaks occurred in four patients in group A (2.1%) and in twelve patients in group B (6.2%) with statistically significant (P = 0.038). During the evaluation of benign stricture seven patients were excluded for hospital mortality. Thirty three patients in group A (6.9%) and 25 patients in group B (13.2%) occurred anastomotic stricture respectively (P = 0.044). Furthermore, reflux oesophagitis and Barrett's epithelium were found in 105 patients (55.3%) of group B, and 54 (28.7%) patients in group A (P < 0.001).


CONCLUSIONS
The oesophageal flap valvuloplasty and wrapping suturing technique decreased anastomotic leakage incidence and stricture rate thereby decreasing the morbidity and mortality. This procedure also prevented the occurrence of gastroesophageal reflux after esophagectomy.
Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.
Q X
QX
Liu
Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.
X F
XF
Deng
Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.
J S
JS
Wang
Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.
B
B
Hou
Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.
J M
JM
Li
Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.
J X
JX
Min
Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China. Electronic address: 691057831@qq.com.
J G
JG
Dai
D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D057868:Anastomotic Leak / Q000517:prevention & control*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005764:Gastroesophageal Reflux / Q000517:prevention & control*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D013270:Stomach / Q000601:surgery*; D013524:Surgical Flaps; D013536:Suture Techniques; D016896:Treatment Outcome
Gastroesophageal reflux; Oesophageal cancer; Surgery