Effectiveness of sternocleidomastoid flap repair for cervical anastomotic leakage after esophageal reconstruction.
OBJECTIVE
The purpose of this study was to investigate the effectiveness of sternocleidomastoid (SCM) flap repair for anastomotic leakage after esophagectomy.


METHODS
A refractory cutaneous fistula from the gastric stump developed in 8 patients with esophageal cancer who underwent esophagogastric anastomosis after esophagectomy. All patients underwent SCM flap repair. The cutaneous fistula was removed and resutured. The sternal head of the left SCM was dissected from the manubrium of the sternum and sutured onto the repaired gastric stump.


RESULTS
The operative duration was 80-220 min (median, 120 min). The amount of intraoperative bleeding ranged from 5 to 182 g (median, 15 g). The absence of recurrent anastomotic leakage was confirmed after the SCM flap repair in every patient. Oral intake was initiated 7-15 days (median, 10 days) after the repair operation without discomfort.


CONCLUSIONS
SCM flap repair is an effective and minimally invasive treatment method for cervical anastomotic leakage after esophageal reconstruction. This method may be considered in patients with refractory leakage of the gastric stump after staple anastomosis.
Department of Surgery I, Dokkyo Medical University, Mibu, Japan.
Masanobu
M
Nakajima
Hitoshi
H
Satomura
Masakazu
M
Takahashi
Hiroto
H
Muroi
Hiroyuki
H
Kuwano
Hiroyuki
H
Kato
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D057868:Anastomotic Leak / Q000175:diagnosis / Q000601:surgery*; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects* / Q000379:methods; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009334:Neck Muscles / Q000637:transplantation; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D013524:Surgical Flaps / Q000098:blood supply / Q000637:transplantation*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology