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Successful cervicothoracic esophageal stricture treatment with partial sternectomy and a pedicled TAAP flap: A case report

Postoperative benign esophageal anastomotic leakage and stenosis are common complications after esophagectomy. Treatment options for anastomosis stenosis include endoscopic mechanical dilation, dilation-combined steroid injection, incisional therapy, stent placement, and self-bougienage. However, lo...

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Autores principales: Li, Baofei, Wang, Haiyang, Liu, Jun, Mu, Xiaosong, Xu, Feng, Deng, Di, Qiao, Yixin, Wang, Shipin, Chen, Fei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9869483/
https://www.ncbi.nlm.nih.gov/pubmed/36700029
http://dx.doi.org/10.3389/fsurg.2022.905241
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author Li, Baofei
Wang, Haiyang
Liu, Jun
Mu, Xiaosong
Xu, Feng
Deng, Di
Qiao, Yixin
Wang, Shipin
Chen, Fei
author_facet Li, Baofei
Wang, Haiyang
Liu, Jun
Mu, Xiaosong
Xu, Feng
Deng, Di
Qiao, Yixin
Wang, Shipin
Chen, Fei
author_sort Li, Baofei
collection PubMed
description Postoperative benign esophageal anastomotic leakage and stenosis are common complications after esophagectomy. Treatment options for anastomosis stenosis include endoscopic mechanical dilation, dilation-combined steroid injection, incisional therapy, stent placement, and self-bougienage. However, long-segmental cervicothoracic esophageal stenosis and cutaneous fistula are always refractory to conservative treatments and are clinically challenging. When lesions extend well below the thoracic inlet, transthoracic esophagectomy and alimentary canal reconstruction seem to be the common choice but are susceptible to perioperative mortality and donor-site sequelae, especially for patients with poor health conditions. In this report, we present a novel surgical approach for cervicothoracic esophageal stenosis and fistula via partial sternectomy and reconstruction with a pedicled thoracoacromial artery perforator flap. No recurrence or complications occurred throughout 3 months of follow-up. This case study adds new perspectives to the treatment of anastomotic stenosis.
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spelling pubmed-98694832023-01-24 Successful cervicothoracic esophageal stricture treatment with partial sternectomy and a pedicled TAAP flap: A case report Li, Baofei Wang, Haiyang Liu, Jun Mu, Xiaosong Xu, Feng Deng, Di Qiao, Yixin Wang, Shipin Chen, Fei Front Surg Surgery Postoperative benign esophageal anastomotic leakage and stenosis are common complications after esophagectomy. Treatment options for anastomosis stenosis include endoscopic mechanical dilation, dilation-combined steroid injection, incisional therapy, stent placement, and self-bougienage. However, long-segmental cervicothoracic esophageal stenosis and cutaneous fistula are always refractory to conservative treatments and are clinically challenging. When lesions extend well below the thoracic inlet, transthoracic esophagectomy and alimentary canal reconstruction seem to be the common choice but are susceptible to perioperative mortality and donor-site sequelae, especially for patients with poor health conditions. In this report, we present a novel surgical approach for cervicothoracic esophageal stenosis and fistula via partial sternectomy and reconstruction with a pedicled thoracoacromial artery perforator flap. No recurrence or complications occurred throughout 3 months of follow-up. This case study adds new perspectives to the treatment of anastomotic stenosis. Frontiers Media S.A. 2023-01-06 /pmc/articles/PMC9869483/ /pubmed/36700029 http://dx.doi.org/10.3389/fsurg.2022.905241 Text en © 2023 Li, Wang, Liu, Mu, Xu, Deng, Qiao, Wang and Chen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Li, Baofei
Wang, Haiyang
Liu, Jun
Mu, Xiaosong
Xu, Feng
Deng, Di
Qiao, Yixin
Wang, Shipin
Chen, Fei
Successful cervicothoracic esophageal stricture treatment with partial sternectomy and a pedicled TAAP flap: A case report
title Successful cervicothoracic esophageal stricture treatment with partial sternectomy and a pedicled TAAP flap: A case report
title_full Successful cervicothoracic esophageal stricture treatment with partial sternectomy and a pedicled TAAP flap: A case report
title_fullStr Successful cervicothoracic esophageal stricture treatment with partial sternectomy and a pedicled TAAP flap: A case report
title_full_unstemmed Successful cervicothoracic esophageal stricture treatment with partial sternectomy and a pedicled TAAP flap: A case report
title_short Successful cervicothoracic esophageal stricture treatment with partial sternectomy and a pedicled TAAP flap: A case report
title_sort successful cervicothoracic esophageal stricture treatment with partial sternectomy and a pedicled taap flap: a case report
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9869483/
https://www.ncbi.nlm.nih.gov/pubmed/36700029
http://dx.doi.org/10.3389/fsurg.2022.905241
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