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Endoscopic stapling technique for redundant free jejunal interposition graft
C A Gutschow1, H Schäfer, K T E Beckurts
1Department of Visceral and Vascular Surgery, University of Cologne, Germany.
Summary
Jejunal interposition for cervical esophagus reconstruction can cause dysphagia due to diverticula. Transoral endoscopic stapling successfully divided a diverticular wall, resolving complete aphagia and restoring oral intake.
Area of Science:
- Gastroenterology and Surgical Innovation
- Esophageal Surgery and Reconstruction
Background:
- Dysphagia is a potential complication following cervical esophagus reconstruction using jejunal interposition.
- Redundancy of the jejunal graft can lead to diverticulum formation, contributing to swallowing difficulties.
Observation:
- A patient presented with complete aphagia two months post-surgery for cervical esophagus reconstruction.
- The aphagia was attributed to a diverticulum arising from the jejunal interposition graft.
Findings:
- Transoral division of the common wall between the diverticulum and the descending jejunal limb was performed using an endoscopic stapling device.
- This minimally invasive endoscopic approach effectively treated the dysphagia.
Implications:
- Endoscopic stapling offers a viable transoral solution for managing dysphagia caused by jejunal interposition diverticula.
- Successful treatment restored the patient's ability to swallow, improving quality of life post-esophageal surgery.