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PubMed1965

[ESOPHAGOPLASTY].

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Esophageal Neoplasms↗
PubMed1985

Small bowel esophagoplasty with vascular microanastomoses in the neck for treatment of esophageal burns in childhood.

Replacement of the esophagus may become mandatory in esophageal burns if dilatation treatment is unsuccessful. Normally, the isoperistaltic transverse colon placed in the neck is used for this purpose. The use of the major curvature of the stomach, according to Gavriliu, may also be considered. In two of our patients, these techniques could not be applied, and we transplanted a portion of the small bowel into the neck, with the blood supply to the pedicule being provided by vascular microanastomosis in the cervical region. The functional results were very satisfying in both cases, despite of the bent appearance of the grafts. At long-term follow-up, there have been no major, particularly peptic, complications. The two cases and the technique applied are described.

Burns, Chemical↗
PubMed1982

Ischemic stricture of the intrathoracic roux loop used for esophagoplasty.

Three cases of stenosis of a Roux loop are presented, following the replacement of the lower third of the esophagus resected for cancer. In each case fibrotic stenosis developed 6 weeks after reconstruction, which was attributed to ischemia: in one case it was due to reduced blood flow during digitalization and in the other two cases to the vascular compression of the supplying vessels because of unsatisfactory dilatation of the hiatus.

Adult↗
PubMed1988

[The incomplete esophagoplasty].

When esophageal reconstruction has to be repeated the most usual reason is the inadequate length of the transplant. This is mainly due to unfavorable vascular architecture, necrosis of the proximal end, and tactical or technical errors in selection and placement of the transplant and the evaluation of vascular supply and length. Mobilization of the transplant is a relatively low-risk method used in esophageal reconstruction. In some cases remobilization can be combined with transfer of the transplant from the subcutaneous channel to the retrosternal space. The indications for repeat esophageal reconstruction with new transplant material are necrosis or malignant degeneration of the transplant and failure of attempts to reuse the initial transplant.

Adolescent↗
PubMedDate not supplied

Plasma levels of glucagon-like polypeptides in patients with esophagoplasty.

Seven patients with interposition of a jejunal tract between the esophagus and stomach or duodenum (EP group) and ten healthy normal volunteers have been submitted to an oral glucose load (OGTT) to clarify the significance of glucagon-like polypeptides (GLI) induced by glucose in carbohydrate metabolism. Blood glucose (BG) and GLI plasma levels were significantly higher in the EP group than in the normal one (p less than 0.01), respectively 30, 60, 90 min for BG and during all the test for GLI. The fasting immunoreactive glucagon (IRG) plasma levels were significantly lower in patients than in normals (p less than 0.05) whereas a marked and significant increase was observed in the EP group (p less than 0.01) from 90 to 240 min. The precocious stimulation of jejunal mucosa and the rapid intestinal transit which occur in these patients may explain the elevated GLI (probably glicentin) plasma levels. The rise in IRG plasma levels might be due to the enzymatic transformation of glicentin. The role of these types of glucagon on carbohydrate metabolism is still to be fully clarified.

Aged↗
PubMedDate not supplied

Efficacy of gastric blood supply redistribution by transarterial embolization: preoperative procedure to prevent postoperative anastomotic leaks following esophagoplasty for esophageal carcinoma.

PURPOSE: The aim of this study was to evaluate the effect of preoperative redistribution of gastric blood supply on the prevention of anastomotic leakage following surgical reconstruction of the esophagus. METHODS: In 37 patients with esophageal carcinoma, transarterial embolization (TAE) of the left gastric, right gastric, and splenic arteries was preoperatively performed with coils so that gastric blood supply was dependent only on the right gastroepiploic artery. RESULTS: In 34 of 37 patients, preoperative redistribution was successfully performed. The gastric tissue blood flow (TBF) of a gastric tube was higher than in 12 nonredistributed patients. Reduction in the gastric TBF during preparation of a gastric tube was 27.5% in successful patients, in contrast to 68.9% in 12 nonredistributed patients (p < 0.005). CONCLUSION: Preoperative redistribution by TAE reduced the drop in gastric TBF during preparation of a gastric tube and helped prevent postoperative anastomotic leakage in esophageal reconstruction.

Adult↗