Endoscopic evaluation of the quality of the anastomosis after esophagectomy with gastric tube reconstruction

Hyun Koo Kim, Young Ho Choi, Jae Hoon Shim, Yang Hyun Cho, Man Jong Baek, Young Sang Sohn, Hark Jei Kim

Research output: Contribution to journalArticle

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Abstract

Background: The morbidity and mortality of anastomotic complications after esophagectomy have gradually decreased in recent years. However, swallowing difficulties and reflux continue to burden patients jeopardizing their quality of life. In the present study we performed endoscopic evaluation of the outcomes of esophagogastrostomy by analyzing the presence of anastomotic stenosis and reflux esophagitis. Methods: A retrospective analysis was carried out on 74 patients who underwent esophagogastrostomy after esophagectomy by one surgeon between January 1995 and December 2004. Fifty-three patients had an endoscopic examination during follow-up (29 ± 23.6 months, range = 5-111 months). Reflux esophagitis and stenosis at the anastomostic site were analyzed according to the surgical technique used and the location of the esophagogastrostomy. Results: The mean age at the time of repair was 60.3 ± 8.87 (range = 39-81) years. Cervical anastomosis was performed in 26 patients and intrathoracic anastomosis in 27 patients. No significant statistical difference in the frequency of anastomotic stenosis was observed between the two groups (p = 0.829); reflux esophagitis was noted in three patients in the cervical anastomosis group and in 14 patients in the intrathoracic anastomosis group (p = 0.041). For all patients, 23 received a hand-sewn esophagogastric anastomosis and 30 a circular stapled one. There was no significant statistical difference in anastomotic stenosis (p = 0.689) and reflux esophagitis (p = 0.879) in comparisons between the two groups. Conclusion: Cervical anastomosis resulted in a better outcome for esophagogastrostomy by lowering the risk of reflux esophagitis; this outcome might improve the patient's quality of life.

Original languageEnglish
Pages (from-to)2010-2014
Number of pages5
JournalWorld Journal of Surgery
Volume32
Issue number9
DOIs
Publication statusPublished - 2008 Sep 1

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Esophagectomy
Stomach
Peptic Esophagitis
Pathologic Constriction
Quality of Life
Deglutition
Hand
Morbidity
Mortality

ASJC Scopus subject areas

  • Surgery

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Endoscopic evaluation of the quality of the anastomosis after esophagectomy with gastric tube reconstruction. / Kim, Hyun Koo ; Choi, Young Ho; Shim, Jae Hoon; Cho, Yang Hyun; Baek, Man Jong; Sohn, Young Sang; Kim, Hark Jei.

In: World Journal of Surgery, Vol. 32, No. 9, 01.09.2008, p. 2010-2014.

Research output: Contribution to journalArticle

Kim, Hyun Koo ; Choi, Young Ho ; Shim, Jae Hoon ; Cho, Yang Hyun ; Baek, Man Jong ; Sohn, Young Sang ; Kim, Hark Jei. / Endoscopic evaluation of the quality of the anastomosis after esophagectomy with gastric tube reconstruction. In: World Journal of Surgery. 2008 ; Vol. 32, No. 9. pp. 2010-2014.
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AU - Sohn, Young Sang

AU - Kim, Hark Jei

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N2 - Background: The morbidity and mortality of anastomotic complications after esophagectomy have gradually decreased in recent years. However, swallowing difficulties and reflux continue to burden patients jeopardizing their quality of life. In the present study we performed endoscopic evaluation of the outcomes of esophagogastrostomy by analyzing the presence of anastomotic stenosis and reflux esophagitis. Methods: A retrospective analysis was carried out on 74 patients who underwent esophagogastrostomy after esophagectomy by one surgeon between January 1995 and December 2004. Fifty-three patients had an endoscopic examination during follow-up (29 ± 23.6 months, range = 5-111 months). Reflux esophagitis and stenosis at the anastomostic site were analyzed according to the surgical technique used and the location of the esophagogastrostomy. Results: The mean age at the time of repair was 60.3 ± 8.87 (range = 39-81) years. Cervical anastomosis was performed in 26 patients and intrathoracic anastomosis in 27 patients. No significant statistical difference in the frequency of anastomotic stenosis was observed between the two groups (p = 0.829); reflux esophagitis was noted in three patients in the cervical anastomosis group and in 14 patients in the intrathoracic anastomosis group (p = 0.041). For all patients, 23 received a hand-sewn esophagogastric anastomosis and 30 a circular stapled one. There was no significant statistical difference in anastomotic stenosis (p = 0.689) and reflux esophagitis (p = 0.879) in comparisons between the two groups. Conclusion: Cervical anastomosis resulted in a better outcome for esophagogastrostomy by lowering the risk of reflux esophagitis; this outcome might improve the patient's quality of life.

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