scholarly journals Clinical Experience of Enteral Feeding Catheter Placement via the Diaphragm During Esophagectomy and Gastric Tube Reconstruction via the Posterior Mediastinal Route

2021 ◽  
Vol 69 (5) ◽  
pp. 510-515
Author(s):  
Masashi ZUGUCHI ◽  
Reijiro SAITO ◽  
Yusuke SAITO ◽  
Kazuki FUSEGAWA ◽  
Daisuke ISHII ◽  
...  
Keyword(s):  
Clinical Experience ◽  
Enteral Feeding ◽  
Gastric Tube ◽  
Catheter Placement ◽  
Posterior Mediastinal ◽  
Posterior Mediastinal Route ◽  
Gastric Tube Reconstruction

Feeding catheter gastrostomy at esophagectomy with gastric tube reconstruction through posterior mediastinal route

Esophagus ◽  
2011 ◽  
Vol 8 (3) ◽  
pp. 217-223 ◽  
Author(s):  
Itasu Ninomiya ◽  
Isamu Makino ◽  
Takashi Fujimura ◽  
Sachio Fushida ◽  
Katsunobu Oyama ◽  
...  
Keyword(s):  
Gastric Tube ◽  
Posterior Mediastinal ◽  
Posterior Mediastinal Route ◽  
Gastric Tube Reconstruction

scholarly journals Two Cases of Hiatal Hernia after Esophagectomy with Gastric Tube Reconstruction via Posterior Mediastinal Route

2017 ◽  
Vol 50 (11) ◽  
pp. 928-936
Author(s):  
Kosuke Sasaki ◽  
Yuichi Morishima ◽  
Yasuyoshi Toyoda ◽  
Daisuke Satomi ◽  
Satoshi Fukutomi ◽  
...  
Keyword(s):  
Hiatal Hernia ◽  
Gastric Tube ◽  
Posterior Mediastinal ◽  
Posterior Mediastinal Route ◽  
Gastric Tube Reconstruction

PS01.120: INVESTIGATION OF NUTRITIONAL INDICATORS COMPARING RECONSTRUCTION ROUTE AFTER ESOPHAGECTOMY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 84-84
Author(s):  
Akihiro Tokuhisa ◽  
Shinsuke Kanekiyo ◽  
Shigeru Takeda ◽  
Hiroaki Nagano
Keyword(s):  
Survival Rate ◽  
Propensity Score ◽  
Surgical Complications ◽  
Gastric Tube ◽  
Nutritional Evaluation ◽  
Endoscopic Findings ◽  
First Choice ◽  
Posterior Mediastinal ◽  
Conut Score ◽  
Gastric Tube Reconstruction

Abstract Background The gastric tube reconstruction route after esophagectomy is generally adopted posterior mediastinal or retrosternal route. Currently it is selected for each hospital or case. Preoperative and postoperative nutritional assessment, surgical complications and rate of survival are retrospectively compared between Posterior mediastinal routec(Group P) and Retrosternal route (Group R). Methods From January 2006 to December 2015, 198 patients with gastric tube reconstruction after esophagectomy (112 patients in Group P and 86 patients in Group R) were included. Propensity score was calculated and adjusted by multiple logistic regression analysis because bias of background factors occurs. 1) Surgical complications and survival rate, 2) CONUT score as a nutritional evaluation index before, 6 months and 12 months after surgery, 3) Endoscopic findings at 12 months after surgery were examined. Results In Group R, there were more advanced cases with thoracotomy than Group P. As a result of matching these factors as covariates using Propensity score, 27 groups were extracted in each group. 1) Surgical complications and survival rate: There was no difference in the incidence of complications such as arrhythmia, suture failure, pulmonary complications between the two groups. There was no difference between PFS and OS in the two groups. 2) Nutritional Evaluation Indicator: The patients who recognized malnutrition (CONUT score 3 or more) before surgery (group P 9.3% vs. group R 7.4%, P = 0.715), 6 months after surgery (18.0% vs 15.4%, P = 1.000), 12 months after surgery (8.6% vs 22.9%, P = 0.049), group P had good nutritional status for 12 months postoperatively. 3) Endoscopic findings: Anastomotic stenosis (group P 22.5% vs. group R 10.2%, P = 0.052) tended to be few in group R. The occurrence of reflux esophagitis and food residue stagnation was not different between both groups. Conclusion Although short-term benefits such as ease of response to postoperative recurrence and postoperative complications are considered to be in retrosternal reconstruction, as the results of esophageal cancer treatment outcome improve, longer term of nutrition etc is taken from the viewpoint. The posterior mediastinal route is the first choice in our department. Disclosure All authors have declared no conflicts of interest.

62 THE STERNO-TRACHEAL DISTANCE IS AN IMPORTANT FACTOR OF ANASTOMOTIC LEAKAGE OF RETROSTERNAL GASTRIC TUBE RECONSTRUCTION AFTER ESOPHAGECTOMY

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
S Inoue
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Anastomotic Leakage ◽  
Gastric Tube ◽  
Independent Risk Factor ◽  
Cutoff Value ◽  
Subtotal Esophagectomy ◽  
Posterior Mediastinal ◽  
Route Reconstruction ◽  
Gastric Tube Reconstruction

Abstract Background Anastomotic leakage (AL) is a serious complication after esophagectomy. The retrosternal (RS) route has been selected majorly to reduce reflux and related pneumonia and considering mediastinal recurrences. AL has been developed more in RS than posterior mediastinal (PM) route reconstruction. Therefore, we suspected the sterno-tracheal distance (STD) might be related to AL and started the selection according to the STD from 2009. Methods A total of 221 patients who underwent a subtotal esophagectomy with gastric tube reconstruction during January 2004—April 2017 were investigated. The patients were classified into the 'after STD selection' (A; n = 144) group and the 'before STD selection' (B, n = 77) group. The incidences of and the risk factors for AL between the two groups were compared. Results The incidence of AL was high in the B group (18.2%), and 78.6% of the patients who developed AL were treated with RS route. The median STDs of the patients with AL and no AL were 10.3 mm and 14.5 mm, respectively (p = 0.001). These results demonstrated that the STD was a risk factor for AL in the RS route. Based on these results, 13 mm was set as the cutoff value. After STD selection, the median STD increased from 14.0 mm to 17.3 mm (p = 0.001), and the incidence of AL decreased significantly from 26.2% to 11.1% in the RS route (p = 0.037). Conclusion The STD was the independent risk factor for AL in the RS route. RS route reconstruction should be avoided for the patients with STD <13 mm.

scholarly journals Two cases of endoscopic submucosal dissection for gastric tube cancers reconstructed through the posterior mediastinal route

2015 ◽  
Vol 87 (1) ◽  
pp. 126-127
Author(s):  
Eiko Okamoto ◽  
Katsunori Ami ◽  
Yuko Karakama ◽  
Mayumi Kondoh ◽  
Hidetaka Akita ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Gastric Tube ◽  
Submucosal Dissection ◽  
Posterior Mediastinal ◽  
Posterior Mediastinal Route

670 THE STERNO-TRACHEAL DISTANCE IS AN IMPORTANT FACTOR OF ANASTOMOTIC LEAKAGE OF RETROSTERNAL GASTRIC TUBE RECONSTRUCTION AFTER ESOPHAGECTOMY

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Seiya Inoue
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Anastomotic Leakage ◽  
Gastric Tube ◽  
Independent Risk Factor ◽  
Cutoff Value ◽  
Posterior Mediastinal ◽  
Total Esophagectomy ◽  
Route Reconstruction ◽  
Gastric Tube Reconstruction

Abstract   Anastomotic leakage (AL) is a serious complication after esophagectomy. The retrosternal (RS) route has been selected majorly to reduce reflux and related pneumonia and considering mediastinal recurrences. AL has been developed more in RS than posterior mediastinal (PM) route reconstruction. Therefore, we suspected the sterno-tracheal distance (STD) might be related to AL and started the selection according to the STD from 2009. Methods A total of 221 patients who underwent a sub total esophagectomy with gastric tube reconstruction during January 2004—April 2017 were investigated. The patients were classified into the 'after STD selection' (A; n = 144) group and the 'before STD selection' (B, n = 77) group. The incidences of and the risk factors for AL between the two groups were compared. Results The incidence of AL was high in the B group (18.2%), and 78.6% of the patients who developed AL were treated with RS route reconstruction. The median STDs of the patients with AL and no AL were 10.3 mm and 14.5 mm, respectively (p = 0.001). These results demonstrated that the STD was a risk factor for AL in RS route. Based on these results, 13 mm was set as the cutoff value. After STD selection, the median STD increased from 14.0 mm to 17.3 mm (p = 0.001), and the incidence of AL decreased significantly from 26.2% to 11.1% in RS route (p = 0.037). Conclusion The STD was the independent risk factor for AL in the RS route. RS route reconstruction should be avoided for the patients with STD <13 mm.

scholarly journals Chylothorax after esophagectomy treated with inguinal intranodal lymphangiography and transvenous retrograde thoracic duct embolization

2021 ◽  
Author(s):  
Yuta Sato ◽  
Yoshihiro Tanaka ◽  
Takeharu Imai ◽  
Hiroshi Kawada ◽  
Naoki Okumura ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Thoracic Duct ◽  
Gastric Tube ◽  
Treatment Options ◽  
Effective Treatment Option ◽  
Major Morbidity ◽  
Posterior Mediastinal ◽  
Posterior Mediastinal Route ◽  
Intranodal Lymphangiography ◽  
High Output

AbstractChylothorax after esophagectomy is a serious complication that is associated with major morbidity due to dehydration and malnutrition. Reoperation with ligation of the thoracic duct is considered for patients with high-output chyle leaks that have failed conservative management. In this report, we present the treatment options for chylothorax after esophagectomy: inguinal intranodal lymphangiography and transvenous retrograde thoracic duct embolization. A 74-year-old man with esophageal cancer had been operated with thoracoscopic esophagectomy. Six days after surgery, he presented with high-output chyle leaks. Conservative treatment did not result in a significant improvement. Inguinal intranodal lymphangiography and transvenous retrograde thoracic duct embolization were performed 13 days after surgery and were technically and clinically successful. Inguinal intranodal lymphangiography and transvenous retrograde thoracic duct embolization are an effective treatment option, especially for patients after esophagectomy with reconstruction performed via the posterior mediastinal route, without the potential for damage the gastric tube and omentum.

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