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Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment

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Upper digestive tract reconstruction for caustic injuries.

Mircea Chirica¹, Marie-Dominique Brette, Matthieu Faron

¹Departments of *General, Endocrine, and Digestive Surgery †Otorhinolaryngology, Saint-Louis Hospital, APHP, Université Paris Diderot, Paris, France.

Annals of Surgery

|May 23, 2014

Summary

This summary is machine-generated.

Colopharyngoplasty impairs long-term functional outcomes for upper digestive tract caustic injuries compared to esophagocoloplasty. Pharyngeal reconstruction negatively impacts success rates, especially in older patients.

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Area of Science:

Gastroenterology
Surgical Reconstruction
Toxicology

Background:

Severe pharyngoesophageal caustic injuries necessitate simultaneous esophageal and pharyngeal reconstruction.
Colopharyngoplasty aims to restore nutritional autonomy in affected patients.

Purpose of the Study:

To compare short- and long-term outcomes of colopharyngoplasty versus esophagocoloplasty for upper digestive tract caustic injuries.
To evaluate survival, functional success, and quality of life after these reconstructive procedures.

Main Methods:

A retrospective study included 116 patients undergoing colopharyngoplasty and 122 undergoing esophagocoloplasty for caustic injuries (1993-2012).
Outcomes analyzed included survival (Kaplan-Meier), functional success (nutritional autonomy), and quality of life (QLQ-OG25, SF12v2).

Main Results:

Survival rates were similar between groups at 1, 5, and 10 years (92%, 74-83%, 67-73%).
Functional success was significantly lower after colopharyngoplasty (57%) compared to esophagocoloplasty (95%) (P < 0.0001).
Older age and pharyngeal reconstruction were associated with failure, particularly in colopharyngoplasty patients over 55.

Conclusions:

Associating pharyngeal reconstruction during esophageal reconstruction for caustic injuries negatively impacts long-term functional outcomes.
Esophagocoloplasty demonstrates superior functional results compared to colopharyngoplasty for upper digestive tract caustic injuries.