AIM:To compare postoperative quality of life (QOL) in patients with gastric cancer treated by esophagogastrostomy reconstruction after proximal gastrectomy.METHODS: QOL assessments that included functional outcomes (a...AIM:To compare postoperative quality of life (QOL) in patients with gastric cancer treated by esophagogastrostomy reconstruction after proximal gastrectomy.METHODS: QOL assessments that included functional outcomes (a 24-item survey about treatment-specific symptoms) and health perception (Spitzer QOL Index) were performed in 149 patients with gastric cancer in the upper third of the stomach, who had received proximal gastrectomy with additional esophagogastrostomy.RESULTS: Fifty-four patients underwent reconstruction by esophagogastric anterior wall end-to-side anastomosis combined with pyloroplasty (EA group); 45 patients had reconstruction by esophagogastric posterior wall end-to-side anastomosis (EP group); and 50 patients had reconstruction by esophagogastric end-to-end anastomosis (EE group). The EA group showed the best postoperative QOL, such as recovery of body weight, less discomfort after meals, and less heart burn or belching at 6 and 24 mo postoperatively. However, the survival rates, surgical results and Spitzer QOL index were similar among the three groups.CONCLUSION: Postoperative QOL was better in the EA than EP or EE group. To improve QOL after proximal gastrectomy for upper third gastric cancer, the EA procedure using a stapler is safe and feasible for esophagogastrostomy.展开更多
The results of 31 cases of sutureless esophagogastrostomy by intraluminal elastic circular ligation (IECL) with the biodegradable supporting tube were reported. The fate of the supporting tube could be tracked satisfa...The results of 31 cases of sutureless esophagogastrostomy by intraluminal elastic circular ligation (IECL) with the biodegradable supporting tube were reported. The fate of the supporting tube could be tracked satisfactorily by X-ray, The tube-dislodge time was 15.03 +/- 2.23 days and unaffected by the size of supporting tube or the site of anastomosis, The supporting tube could be safely absorbed or partially discharged through the alimentary tract. IECL, with the merits of saving time, anastomosing tightly and leaving no suture materials in the anastomotic site, can be expected to further reduce the incidence of anastomotic leakage and provide references for other gastrointestinal anastomosis.展开更多
Patients with esophageal cancer often require esophagectomy with esophagogastrostomy.However,the incidence of complications,such as hemorrhage,during operations for esophageal cancer is high,even with minimally invasi...Patients with esophageal cancer often require esophagectomy with esophagogastrostomy.However,the incidence of complications,such as hemorrhage,during operations for esophageal cancer is high,even with minimally invasive surgery.Without the appropriate interventions,the risk of major intraoperative and postoperative hemorrhage is very high in patients with esophageal cancer and hemophilia.We report the case of a 45-year-old man with esophageal cancer and hemophilia B who underwent a successful hybrid,minimally invasive Ivor-Lewis esophagectomy with appropriate perioperative management.展开更多
BACKGROUND Gastric tube formation and pull-up is the most common technique of reconstruction following esophagectomy for esophageal cancer.If previous treatment with radiotherapy for gastric mucosa-associated lymphoid...BACKGROUND Gastric tube formation and pull-up is the most common technique of reconstruction following esophagectomy for esophageal cancer.If previous treatment with radiotherapy for gastric mucosa-associated lymphoid tissue(MALT)-lymphoma restricts suitability of the stomach for anastomosis to the esophagus is unknown.CASE SUMMARY A 57-year-old man underwent sequential chemotherapy and radiotherapy for gastric MALT-lymphoma seven years prior to diagnosis of esophageal adenocarcinoma.Esophagectomy without neoadjuvant treatment was recommended by the multidisciplinary tumor board due to early tumor stage[uT1(sm2)uN+cM0 according to TNM-classification of malignant tumors,8^(th) edition]without lymph node involvement.Minimal invasive esophageal resection with esophagogastrostomy was performed.Due to gastric tube necrosis with anastomotic leakage on the twelfth postoperative day,diverting resection with construction of a cervical salivary fistula was necessary.Rapid recovery facilitated colonic interposition without any complications six months afterwards.CONCLUSION This case report may represent the start for further investigation to know if it is reasonable to refrain from esophagogastrostomy in patients with a long interval between gastric radiotherapy and surgery.展开更多
Dense and extensive esophageal strictures after caustic agent ingestion require surgical treatment. Colon, stomach and jejunum can be used to reconstruct esophagus. Here, we report an unusual patient with corrosive es...Dense and extensive esophageal strictures after caustic agent ingestion require surgical treatment. Colon, stomach and jejunum can be used to reconstruct esophagus. Here, we report an unusual patient with corrosive esophageal stricture who had received unsuccessful esophageal replacements twice at other hospitals. Colon interposition had been first performed 6 months after corrosive esophageal burn, but the colon graft necrosis occurred. Esophageal reconstruction had been carried out 10 years later in another hospital. However, the graft necrosis developed again 5 months later. A salvage operation was performed to remove the necrotic transplant in our hospital. Then as much food as possible had been given to expand the stomach through the gastrostomy since the procedure. The patient underwent esophagecto-my and concomitant gastroesophagostomy in the neck 1. 5 years later. Esophageal dilations had been performed to prevent recurrent anastomotic stricture for 1 year. He has eaten a normal diet since being discharged.展开更多
文摘AIM:To compare postoperative quality of life (QOL) in patients with gastric cancer treated by esophagogastrostomy reconstruction after proximal gastrectomy.METHODS: QOL assessments that included functional outcomes (a 24-item survey about treatment-specific symptoms) and health perception (Spitzer QOL Index) were performed in 149 patients with gastric cancer in the upper third of the stomach, who had received proximal gastrectomy with additional esophagogastrostomy.RESULTS: Fifty-four patients underwent reconstruction by esophagogastric anterior wall end-to-side anastomosis combined with pyloroplasty (EA group); 45 patients had reconstruction by esophagogastric posterior wall end-to-side anastomosis (EP group); and 50 patients had reconstruction by esophagogastric end-to-end anastomosis (EE group). The EA group showed the best postoperative QOL, such as recovery of body weight, less discomfort after meals, and less heart burn or belching at 6 and 24 mo postoperatively. However, the survival rates, surgical results and Spitzer QOL index were similar among the three groups.CONCLUSION: Postoperative QOL was better in the EA than EP or EE group. To improve QOL after proximal gastrectomy for upper third gastric cancer, the EA procedure using a stapler is safe and feasible for esophagogastrostomy.
文摘The results of 31 cases of sutureless esophagogastrostomy by intraluminal elastic circular ligation (IECL) with the biodegradable supporting tube were reported. The fate of the supporting tube could be tracked satisfactorily by X-ray, The tube-dislodge time was 15.03 +/- 2.23 days and unaffected by the size of supporting tube or the site of anastomosis, The supporting tube could be safely absorbed or partially discharged through the alimentary tract. IECL, with the merits of saving time, anastomosing tightly and leaving no suture materials in the anastomotic site, can be expected to further reduce the incidence of anastomotic leakage and provide references for other gastrointestinal anastomosis.
文摘Patients with esophageal cancer often require esophagectomy with esophagogastrostomy.However,the incidence of complications,such as hemorrhage,during operations for esophageal cancer is high,even with minimally invasive surgery.Without the appropriate interventions,the risk of major intraoperative and postoperative hemorrhage is very high in patients with esophageal cancer and hemophilia.We report the case of a 45-year-old man with esophageal cancer and hemophilia B who underwent a successful hybrid,minimally invasive Ivor-Lewis esophagectomy with appropriate perioperative management.
文摘BACKGROUND Gastric tube formation and pull-up is the most common technique of reconstruction following esophagectomy for esophageal cancer.If previous treatment with radiotherapy for gastric mucosa-associated lymphoid tissue(MALT)-lymphoma restricts suitability of the stomach for anastomosis to the esophagus is unknown.CASE SUMMARY A 57-year-old man underwent sequential chemotherapy and radiotherapy for gastric MALT-lymphoma seven years prior to diagnosis of esophageal adenocarcinoma.Esophagectomy without neoadjuvant treatment was recommended by the multidisciplinary tumor board due to early tumor stage[uT1(sm2)uN+cM0 according to TNM-classification of malignant tumors,8^(th) edition]without lymph node involvement.Minimal invasive esophageal resection with esophagogastrostomy was performed.Due to gastric tube necrosis with anastomotic leakage on the twelfth postoperative day,diverting resection with construction of a cervical salivary fistula was necessary.Rapid recovery facilitated colonic interposition without any complications six months afterwards.CONCLUSION This case report may represent the start for further investigation to know if it is reasonable to refrain from esophagogastrostomy in patients with a long interval between gastric radiotherapy and surgery.
文摘Dense and extensive esophageal strictures after caustic agent ingestion require surgical treatment. Colon, stomach and jejunum can be used to reconstruct esophagus. Here, we report an unusual patient with corrosive esophageal stricture who had received unsuccessful esophageal replacements twice at other hospitals. Colon interposition had been first performed 6 months after corrosive esophageal burn, but the colon graft necrosis occurred. Esophageal reconstruction had been carried out 10 years later in another hospital. However, the graft necrosis developed again 5 months later. A salvage operation was performed to remove the necrotic transplant in our hospital. Then as much food as possible had been given to expand the stomach through the gastrostomy since the procedure. The patient underwent esophagecto-my and concomitant gastroesophagostomy in the neck 1. 5 years later. Esophageal dilations had been performed to prevent recurrent anastomotic stricture for 1 year. He has eaten a normal diet since being discharged.
