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Totally mechanical linear stapled anastomosis for minimally invasive Ivor Lewis esophagectomy: Operative technique and short‐term outcomes

BACKGROUND: Anastomosis is one of the important factors affecting anastomotic complications after esophagectomy, and multiple reports have compared anastomotic complications among various techniques. However, there is insufficient evidence in the literature to definitively recommend one anastomotic...

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Autores principales: Gao, Hui‐Jiang, Mu, Ju‐Wei, Pan, Wei‐Min, Brock, Malcolm, Wang, Mao‐Long, Han, Bin, Ma, Kai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7049498/
https://www.ncbi.nlm.nih.gov/pubmed/32012474
http://dx.doi.org/10.1111/1759-7714.13339
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author Gao, Hui‐Jiang
Mu, Ju‐Wei
Pan, Wei‐Min
Brock, Malcolm
Wang, Mao‐Long
Han, Bin
Ma, Kai
author_facet Gao, Hui‐Jiang
Mu, Ju‐Wei
Pan, Wei‐Min
Brock, Malcolm
Wang, Mao‐Long
Han, Bin
Ma, Kai
author_sort Gao, Hui‐Jiang
collection PubMed
description BACKGROUND: Anastomosis is one of the important factors affecting anastomotic complications after esophagectomy, and multiple reports have compared anastomotic complications among various techniques. However, there is insufficient evidence in the literature to definitively recommend one anastomotic technique over another. METHOD: We retrospectively evaluated 34 consecutive patients who underwent an improved totally mechanical side‐to‐side: posterior‐to‐posterior linear stapled (TM‐STS) technique for minimally invasive Ivor Lewis esophagogastric anastomosis, performed by a single surgeon between February 2015 to November 2017. The operative techniques and short‐term outcomes are analyzed in this study. RESULTS: There were no conversions to an open approach and a complete resection was achieved in all patients undergoing this improved procedure. During the first half of the series, the median operation time was 355 minutes, ranging from 257 to 480 minutes. Over the second half of this series, the median operation time was reduced to 256 minutes. There were no mortalities or serious postoperative complications. Only one patient (2.9%) had an anastomotic leak, which resolved without intervention. Another patient (2.9%) experienced transient, delayed conduit emptying which upper gastrointestinal radiography determined was due to a mechanical obstruction caused by an abnormally long gastric tube in the chest cavity. CONCLUSIONS: The results of our study suggest that this improved TM‐STS technique is safe and effective for minimally invasive Ivor Lewis esophagectomy, and can be considered as one of the alternative procedure for patients with lower esophageal as well as Siewert types I/II gastroesophageal junction carcinoma.
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spelling pubmed-70494982020-03-05 Totally mechanical linear stapled anastomosis for minimally invasive Ivor Lewis esophagectomy: Operative technique and short‐term outcomes Gao, Hui‐Jiang Mu, Ju‐Wei Pan, Wei‐Min Brock, Malcolm Wang, Mao‐Long Han, Bin Ma, Kai Thorac Cancer Original Articles BACKGROUND: Anastomosis is one of the important factors affecting anastomotic complications after esophagectomy, and multiple reports have compared anastomotic complications among various techniques. However, there is insufficient evidence in the literature to definitively recommend one anastomotic technique over another. METHOD: We retrospectively evaluated 34 consecutive patients who underwent an improved totally mechanical side‐to‐side: posterior‐to‐posterior linear stapled (TM‐STS) technique for minimally invasive Ivor Lewis esophagogastric anastomosis, performed by a single surgeon between February 2015 to November 2017. The operative techniques and short‐term outcomes are analyzed in this study. RESULTS: There were no conversions to an open approach and a complete resection was achieved in all patients undergoing this improved procedure. During the first half of the series, the median operation time was 355 minutes, ranging from 257 to 480 minutes. Over the second half of this series, the median operation time was reduced to 256 minutes. There were no mortalities or serious postoperative complications. Only one patient (2.9%) had an anastomotic leak, which resolved without intervention. Another patient (2.9%) experienced transient, delayed conduit emptying which upper gastrointestinal radiography determined was due to a mechanical obstruction caused by an abnormally long gastric tube in the chest cavity. CONCLUSIONS: The results of our study suggest that this improved TM‐STS technique is safe and effective for minimally invasive Ivor Lewis esophagectomy, and can be considered as one of the alternative procedure for patients with lower esophageal as well as Siewert types I/II gastroesophageal junction carcinoma. John Wiley & Sons Australia, Ltd 2020-02-03 2020-03 /pmc/articles/PMC7049498/ /pubmed/32012474 http://dx.doi.org/10.1111/1759-7714.13339 Text en © 2020 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Gao, Hui‐Jiang
Mu, Ju‐Wei
Pan, Wei‐Min
Brock, Malcolm
Wang, Mao‐Long
Han, Bin
Ma, Kai
Totally mechanical linear stapled anastomosis for minimally invasive Ivor Lewis esophagectomy: Operative technique and short‐term outcomes
title Totally mechanical linear stapled anastomosis for minimally invasive Ivor Lewis esophagectomy: Operative technique and short‐term outcomes
title_full Totally mechanical linear stapled anastomosis for minimally invasive Ivor Lewis esophagectomy: Operative technique and short‐term outcomes
title_fullStr Totally mechanical linear stapled anastomosis for minimally invasive Ivor Lewis esophagectomy: Operative technique and short‐term outcomes
title_full_unstemmed Totally mechanical linear stapled anastomosis for minimally invasive Ivor Lewis esophagectomy: Operative technique and short‐term outcomes
title_short Totally mechanical linear stapled anastomosis for minimally invasive Ivor Lewis esophagectomy: Operative technique and short‐term outcomes
title_sort totally mechanical linear stapled anastomosis for minimally invasive ivor lewis esophagectomy: operative technique and short‐term outcomes
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7049498/
https://www.ncbi.nlm.nih.gov/pubmed/32012474
http://dx.doi.org/10.1111/1759-7714.13339
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