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Esophageal Strictures-II: Clinical Features and Management01:26

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Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
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An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
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An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
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Mechanical triangular esophagogastrostomy: Technical aspects and initial results.

Alfredo Vivas López1, Elías Rodríguez Cuellar1, Alberto García Picazo1

  • 1Servicio de Cirugía General y del Aparato Digestivo, Hospital 12 de Octubre, Madrid, Spain.

Cirugia Espanola
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Summary

Mechanical triangular esophagogastrostomy (MT) shows promise for esophagogastric anastomosis after esophagectomy, with initial results suggesting safety and potential benefits in reducing complications like anastomotic leak and stenosis.

Keywords:
AnastomosisEsofaguectomíaGastroesophagealTriangular mecánicaTriangulating mechanical

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Area of Science:

  • Surgical Oncology
  • Gastrointestinal Surgery

Background:

  • Esophageal cancer is a significant global health concern, ranking as the eighth most common neoplasm worldwide.
  • Surgical intervention, particularly esophagectomy, is the most effective treatment modality.
  • Esophagogastrostomy techniques are crucial for reconstructing the digestive tract post-esophagectomy.

Purpose of the Study:

  • To describe the technical aspects of mechanical triangular esophagogastrostomy (MT).
  • To evaluate the initial outcomes of MT anastomosis in patients undergoing esophagectomy.
  • To contribute Western literature data on MT anastomosis, a technique with limited published experience.

Main Methods:

  • Retrospective review of patients undergoing esophagectomy with MT anastomosis.
  • Study period: October 2017 to March 2020.
  • McKeown technique was used for esophagectomy.

Main Results:

  • 14 patients included, mean age 63 years.
  • Anastomotic leak (AL) observed in 3 patients (21.4%); anastomotic stenosis (AS) in 3 patients.
  • Median hospital stay was 20 days, with no in-hospital mortality.

Conclusions:

  • MT anastomosis demonstrated comparable or improved outcomes regarding AL and AS compared to existing literature.
  • Despite a small sample size, a trend towards improved indicators was noted after initial cases.
  • MT anastomosis appears to be a safe option for esophagogastric reconstruction, warranting further investigation in larger studies.