Cervical esophagogastric anastomosis with invagination after esophagectomy

Acta Cirurgica Brasileira

Alexandre Cruz Henriques²  Felipe Emanuel Fuhro²  Carlos Alberto Godinho²  Andre Luiz Lopes Cardoso Campos¹  Jaques Waisberg² 

[1] ,FMABC Department of Surgery

关键词: Esophagus;    Esophagectomy;    Constriction;    Pathologic;    Anastomotic Leak;    Gastroplasty;    Esôfago;    Esofagectomia;    Constrição Patológica;    Fistula Anastomótica;    Gastroplastia;   

DOI  :  10.1590/S0102-86502012000500011

来源: SciELO

【 摘 要 】

PURPOSE: To evaluate the incidence of fistula and stenosis of the cervical esophagogastric anastomosis with invagination of the proximal esophageal stump into the stomach after subtotal esophagectomy. METHODS: We studied 54 patients who underwent subtotal esophagectomy, 45 (83.3%) patients with carcinoma and nine (16.6%) with advanced megaesophagus. In all cases the cervical esophagogastric anastomosis was performed with the invagination of the proximal esophageal stump inside the stomach. RESULTS: Three (5.5%) patients had a fistula at the esophagogastric anastomosis, two of whom with minimal leakage of air or saliva and with mild clinical repercussion; the third had a low output fistula that drained into the pleural space, and this patient developed empyema that showed good progress with drainage. Fibrotic stenosis of anastomosis occurred in thirteen (24%) subjects and was treated successfully with endoscopic dilatation. CONCLUSION: Cervical esophagogastric anastomosis with invagination of the proximal esophageal stump into the stomach tube presented a low rate of esophagogastric fistula and stenosis, thus becoming an attractive option for the reconstruction of alimentary transit after subtotal esophagectomy.

【 授权许可】

CC BY   
 All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License