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
We are describing a novel technique to insert nasogastric tube （NGT） in the anesthetized patients dur- ing cervical esophageal reconstruction. Methods： Forty patients with mid and upper esophageal tumor enrolled in...We are describing a novel technique to insert nasogastric tube （NGT） in the anesthetized patients dur- ing cervical esophageal reconstruction. Methods： Forty patients with mid and upper esophageal tumor enrolled into this study were randomly allocated into two groups （the control group, group C and the novel method group, group N）. All the patients were applied mechanical anastomosis to finish the cervical esophageal reconstruction. The procedure of NGT insertion for group C use the conventional method; well, the group N use the novel technique. Results： All the patients in group N had been finished the NGT insertion in the first attempt, and the total time for insertion was （5.05 ＋ 1.15） mins; on the contrary, for the group C, duration of insertion （min） was （24.45 ± 5.23） mins, and the successful rate of NGT insertion in the first attempt was 40% （P〈 0.05）; no one in group N had coiling/kinking, and 6/20 （30%） in group C had it （P= 0.020）. The complication rate of bleeding between the two group had no significant difference. Conclusion： For the patient with mid and upper esophageal tumor who need cervical esophageal reconstruction, this novel method can save the NGT insertion time, and make it easier with higher successful rate.展开更多
From September 1985 to December 1992, 160 cases of reconstruction of the esophagus with the whole stomach through the esophageal bed after resection of the upper esophageal carcinoma were performed with neither operat...From September 1985 to December 1992, 160 cases of reconstruction of the esophagus with the whole stomach through the esophageal bed after resection of the upper esophageal carcinoma were performed with neither operative mortality nor intrathoracic complications. The leakage rate of the cervical anastomosis with Gambee's single layer method was 1.2%. The main steps of the operative procedure consisted of : (1) making a right thoracotomy for dissecting and removing the entire thoracic esophagus; (2) laparotomy for mobilizing the whole stomach, constricting it to tube shape and doing a pyloroplasty; and (3) pulling up the mobilized tube-like stomach through the posterior mediastinal space(i.e. the esophageal bed) out of the left neck incision and then the esophagogastrostomy with Gambee's single layer anastomosis was performed.展开更多
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.
文摘We are describing a novel technique to insert nasogastric tube （NGT） in the anesthetized patients dur- ing cervical esophageal reconstruction. Methods： Forty patients with mid and upper esophageal tumor enrolled into this study were randomly allocated into two groups （the control group, group C and the novel method group, group N）. All the patients were applied mechanical anastomosis to finish the cervical esophageal reconstruction. The procedure of NGT insertion for group C use the conventional method; well, the group N use the novel technique. Results： All the patients in group N had been finished the NGT insertion in the first attempt, and the total time for insertion was （5.05 ＋ 1.15） mins; on the contrary, for the group C, duration of insertion （min） was （24.45 ± 5.23） mins, and the successful rate of NGT insertion in the first attempt was 40% （P〈 0.05）; no one in group N had coiling/kinking, and 6/20 （30%） in group C had it （P= 0.020）. The complication rate of bleeding between the two group had no significant difference. Conclusion： For the patient with mid and upper esophageal tumor who need cervical esophageal reconstruction, this novel method can save the NGT insertion time, and make it easier with higher successful rate.
文摘From September 1985 to December 1992, 160 cases of reconstruction of the esophagus with the whole stomach through the esophageal bed after resection of the upper esophageal carcinoma were performed with neither operative mortality nor intrathoracic complications. The leakage rate of the cervical anastomosis with Gambee's single layer method was 1.2%. The main steps of the operative procedure consisted of : (1) making a right thoracotomy for dissecting and removing the entire thoracic esophagus; (2) laparotomy for mobilizing the whole stomach, constricting it to tube shape and doing a pyloroplasty; and (3) pulling up the mobilized tube-like stomach through the posterior mediastinal space(i.e. the esophageal bed) out of the left neck incision and then the esophagogastrostomy with Gambee's single layer anastomosis was performed.
