Delayed cervical esophagogastric anastomosis

a 5-year experience at the Hospital de Clínicas de Porto Alegre

Authors

  • Leandro T. Cavazzola
  • Richard R. Gursk
  • Carlos C. Schirmer
  • André Ricardo P. da Rosa
  • Guilherme Pesce
  • João Pedro B. Telles
  • Cleber Dario P. Kruel

Keywords:

Esophageal epidermoid carcinoma, surgery, postoperative complications, leakage, death

Abstract

OBJECTIVE: Cervical esophagogastric anastomosis (CEA) is a common procedure used to restore the continuity of the digestive tract following curative or palliative surgery for esophageal cancer. At the HCPA, we carry out CEA procedures in two steps: first, we carry out a lateral cervical esophagostomy and position the esophageal substitute in the neck; second, after one week, the esophageal remnant is sutured to the esophageal substitute. The choice of esophageal substitute is made according to gastric pull-up (GP) or greater curvature gastric tube (GCGT), depending on the possibility of resection of the lesion. The objective of this paper is to describe the early results (up to 30 days) of delayed cervical esophagogastric anastomosis after resection or esophageal bypass procedures due to esophageal neoplasia.

MATERIAL AND METHODS: Fifty-nine patients fulfilled the criteria for inclusion in our study, out of which there were 49 male and 55 white patients; the age average was of 51.5 years. Twenty-two patients were submitted to gastric pull-up. The risk factors for postoperative complications were similar for both groups. Tumor staging was the only difference between the two groups in preoperative examination; this difference was expected according to the criteria used for choosing the procedure.

RESULTS: Seven patients (31.8%) of the GP group and in 9 patients (34.3%) from the GCGT group (RR 1.3; CI 95%: 0.5-3.0, P = 0.54) presented leakage. Two patients (9.1%) from the GP group and 1 (2.7%) from the GCGT group died (RR 3.4; CI 95%: 0.3-34.9, P = 0.54). One patient (4.5%) from the GP group and 7 (18.9%) patients from the GCGT group (RR 0.2; CI 95%: 0.1-1.8, P = 0.23) presented infections. There were no differences between the groups regarding occurrence of leakage, short-term postoperative death (until 30 days after surgery), and infections.

CONCLUSIONS: Our results are similar to those of other services of reference for the treatment of esophageal cancer. In this study, we did not find any differences between the GP and GCGT groups regarding short-term postoperative complications.

Downloads

Download data is not yet available.

Downloads

Published

2022-07-07

How to Cite

1.
T. Cavazzola L, R. Gursk R, C. Schirmer C, P. da Rosa AR, Pesce G, B. Telles JP, P. Kruel CD. Delayed cervical esophagogastric anastomosis: a 5-year experience at the Hospital de Clínicas de Porto Alegre. Clin Biomed Res [Internet]. 2022 Jul. 7 [cited 2025 May 10];21(1). Available from: https://seer.ufrgs.br/index.php/hcpa/article/view/125706

Issue

Vol. 21 No. 1 (2001): Revista HCPA

Section

Original Articles

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).