Esophago-jejunal anastomosis with open approach using the parachute technique to prioritize safety after resection of esophagogastric junction cancer.

IF 2.1 3区 医学 Q2 SURGERY
Tadashi Higuchi, Masahiro Niihara, Hiroyuki Minoura, Hiroki Harada, Motohiro Chuman, Marie Washio, Mikiko Sakuraya, Koshi Kumagai, Yusuke Kumamoto, Takeshi Naitoh, Keishi Yamashita, Naoki Hiki
{"title":"Esophago-jejunal anastomosis with open approach using the parachute technique to prioritize safety after resection of esophagogastric junction cancer.","authors":"Tadashi Higuchi, Masahiro Niihara, Hiroyuki Minoura, Hiroki Harada, Motohiro Chuman, Marie Washio, Mikiko Sakuraya, Koshi Kumagai, Yusuke Kumamoto, Takeshi Naitoh, Keishi Yamashita, Naoki Hiki","doi":"10.1007/s00423-024-03535-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The appropriate extent of resection for esophagogastric junction cancer and the method of surgical approach remain controversial. This study aimed to assess the safety and outcomes of the parachute technique, which is an open transhiatal reconstruction method that facilitates stable reconstruction.</p><p><strong>Materials and methods: </strong>The surgical outcomes of 20 consecutive patients who underwent open lower- esophagogastrectomy for EGJ cancer at Kitasato University Hospital from June 2019 to July 2023 were retrospectively reviewed.</p><p><strong>Surgical procedure (parachute technique): </strong>The esophagus was transected, and a purse-string suture was placed at the stump. Then, a fixing string was placed. Hence, the mucosa, muscular layer, and adventitia, including the string of the purse-string suture, were not displaced. By placing approximately 10 stay sutures around the whole esophageal stump, the esophageal stump can be opened to the maximum diameter. Then, insert the anvil head into the esophagus lumen while laying it sideways, and it can be put on smoothly without stress.</p><p><strong>Results: </strong>In total, there were 17 and 3, male and female patients, respectively. The median esophageal invasion length was 12.5 (0-30) mm. One patient presented with cStage I EGJ cancer, four with cStage II, 14 with cStage III, and one with cStage IV. In terms of postoperative complications, three (15%) patients developed grade II intra-abdominal fluid correction according to the Clavien-Dindo classification. However, none of the patients presented with anastomotic leakage.</p><p><strong>Conclusions: </strong>The parachute technique can be a safe and effective reconstruction technique as it does not cause anastomotic leakage.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"409 1","pages":"364"},"PeriodicalIF":2.1000,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Langenbeck's Archives of Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00423-024-03535-1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: The appropriate extent of resection for esophagogastric junction cancer and the method of surgical approach remain controversial. This study aimed to assess the safety and outcomes of the parachute technique, which is an open transhiatal reconstruction method that facilitates stable reconstruction.

Materials and methods: The surgical outcomes of 20 consecutive patients who underwent open lower- esophagogastrectomy for EGJ cancer at Kitasato University Hospital from June 2019 to July 2023 were retrospectively reviewed.

Surgical procedure (parachute technique): The esophagus was transected, and a purse-string suture was placed at the stump. Then, a fixing string was placed. Hence, the mucosa, muscular layer, and adventitia, including the string of the purse-string suture, were not displaced. By placing approximately 10 stay sutures around the whole esophageal stump, the esophageal stump can be opened to the maximum diameter. Then, insert the anvil head into the esophagus lumen while laying it sideways, and it can be put on smoothly without stress.

Results: In total, there were 17 and 3, male and female patients, respectively. The median esophageal invasion length was 12.5 (0-30) mm. One patient presented with cStage I EGJ cancer, four with cStage II, 14 with cStage III, and one with cStage IV. In terms of postoperative complications, three (15%) patients developed grade II intra-abdominal fluid correction according to the Clavien-Dindo classification. However, none of the patients presented with anastomotic leakage.

Conclusions: The parachute technique can be a safe and effective reconstruction technique as it does not cause anastomotic leakage.

采用降落伞技术的开放式食管空肠吻合术,优先保证食管胃交界处癌切除术后的安全。
背景:食管胃交界处癌症的适当切除范围和手术方法仍存在争议。本研究旨在评估降落伞技术的安全性和效果,该技术是一种开放式经食管重建方法,有利于稳定重建:回顾性分析了2019年6月至2023年7月在北里大学医院连续接受开放式食管下段切除术的20例食管癌患者的手术效果:手术过程(降落伞技术):横断食管,在残端放置荷包绳缝合线。然后,放置固定绳。因此,黏膜、肌肉层和黏膜前膜,包括荷包绳缝合线都没有移位。在整个食管残端周围放置大约 10 条留置缝线,就能将食管残端打开到最大直径。然后,将砧头插入食管腔内,同时将其侧卧,就可以顺利地将砧头放上去,不会有任何压力:男性和女性患者分别为 17 人和 3 人。中位食管侵犯长度为 12.5(0-30)毫米。1例患者为食管癌I期,4例为II期,14例为III期,1例为IV期。在术后并发症方面,根据克拉维恩-丁多(Clavien-Dindo)分类法,3 名患者(15%)出现了 II 级腹腔积液矫正。然而,没有一名患者出现吻合口漏:降落伞技术不会导致吻合口漏,是一种安全有效的重建技术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
3.30
自引率
8.70%
发文量
342
审稿时长
4-8 weeks
期刊介绍: Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信