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Khirurgiia·2015
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Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment
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Esophagogastrectomy with simultaneous intestinal repair.

A A Chernyavskiy1, N A Lavrov1

  • 1Nizhny Novgorod State Medical Academy, Ministry of Health of the Russian Federation, Nizhny Novgorod, Russia.

Khirurgiia
|September 16, 2016
PubMed
Summary

This study analyzed esophagogastrectomy with intestinal repair for gastroesophageal cancer. Isoperistaltic esophagocoloplasty demonstrated superior functional outcomes, despite a 12.2% mortality rate.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Digestive System Surgery

Background:

  • Gastroesophageal cancer presents complex surgical challenges.
  • Esophagogastrectomy with intestinal reconstruction is a common treatment modality.
  • Optimizing functional outcomes after such extensive surgery is crucial for patient recovery.

Purpose of the Study:

  • To present the treatment outcomes of patients undergoing esophagogastrectomy with simultaneous intestinal repair for gastroesophageal conditions.
  • To evaluate the efficacy and functional results of different intestinal reconstruction techniques.
  • To analyze the surgical approach and associated complications.

Main Methods:

  • Analysis of 41 cases undergoing esophagogastrectomy with intestinal repair (37 malignant, 4 benign).
  • Predominant use of abdominocervical access.
  • Detailed description of surgical techniques, including intrapleural anastomosis when necessary.
  • Evaluation of functional results based on anastomosis techniques.

Main Results:

  • Isoperistaltic esophagocoloplasty yielded better functional results when the graft's aboral end was anastomosed with the Roux-segment of the jejunum or the vertical bend of the duodenum.
  • A mortality rate of 12.2% was observed in the study cohort.
  • High intrapleural anastomosis was utilized in 6 patients due to graft length limitations.

Conclusions:

  • Isoperistaltic repair utilizing left colonic vessels offers superior functional outcomes.
  • Specific anastomosis techniques (end-to-side with jejunum or duodenum) are associated with improved functional results.
  • Careful surgical technique and appropriate graft selection are vital for successful esophagogastrectomy outcomes.