• 1. Department of Cardiothoracic Surgery, The 153 rd Central Hospital of People's Liberation Army, Zhengzhou 450042, P. R. China;
  • 2. Information Center of Land Bureau of Henan Province, Zhengzhou 450042, P. R China;
  • 3. Department of Cardiothoracic Surgery, Anyang Sixth People's Hospital, Anyang 455002, Henan, P. R. China;
  • 4. Department of Thoracic Surgery, Xinzheng People's Hospital, Xinzheng 450062, Henan, P. R China;
LIBao-tian, Email: lbting292@sina.com
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Objective To explore clinical outcomes of complete mechanical cervical side-to-side esophago-gastric tube anastomosis. Methods Clinical data of 60 patients with esophageal carcinoma (EC)who underwent complete mechanical cervical side-to-side esophago-gastric tube anastomosis in the 153rd Central Hospital of People's Liberation Army from June 2010 to June 2012 were retrospectively analyzed. There were 41 male and 19 female patients with their age of 46-78 (64.2±6.4)years and body weight of 58.6±12.6 kg. There were 39 patients with mid-thoracic EC, 15 patients with lower-thoracic EC, and 6 patients with upper-thoracic EC. There was 1 patient with stageⅠ EC, 32 patients with stage Ⅱ EC, 23 patients with stage Ⅲ EC, and 4 patients with stage Ⅳ EC. Six to 12 months after the operation, all the patients received a survey questionnaire regarding their quantity and quality of food intake as well as gastroesophageal reflux (GER). Fifty-two patients received barium swallow, and 38 patients received gastroscopy and esophageal mucosal biopsy during follow-up. Results All the 60 patients were successfully discharged. Average length of hospital stay was 12.0±2.6 days. Average time for anastomosis was 18.4±3.2 minutes. The incidence of anastomotic leak was 1.7% (1/60). During follow-up, all the 60 patients restored normal food intake, and 14 patients (23.3%)had GER symptoms. Barium swallow showed the average anastomotic diameter of 1.6±0.2 cm (range, 1.2 to 2.2 cm). In 45° trendelenburg position, 31 patients (59.6%)had barium GER, but none of the patients had prolonged barium retention, intrathoracic gastric dilation or disturbed gastric emptying. Gastroscopy of 38 patients showed full anastomotic opening in 24 patients (63.2%)and irregular or semiclosed anastomosis in the other 14 patients (36.8%). Mucosal biopsy under gastroscopy showed chronic inflammation in 18.4% (7/38)patients. Conclusion Complete mechanical cervical side-to-side esophago-gastric tube anastomosis can significantly prevent anastomotic stenosis, leak and intrathoracic stomach symptoms with good clinical outcomes.

Citation: ZHOUAi-Xiang, LILing, LIBao-tian, LIUGao-feng, LIDan-dan, QINYun-liang, LVZhi-min. Complete Mechanical Cervical Side-to-side Esophago-gastric Tube Anastomosis in 60 Patients. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(5): 644-647. doi: 10.7507/1007-4848.20140184 Copy

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