Background: In surgery for treating esophageal cancer, the esophageal plastic surgery with stomach tube is the operation of choice. However, there was high rate of anastomotic leakage in the esophageal plastic surgery with stomach tube with neck anastomosis. Objectives: to evaluate the result of the esophageal plastic surgery with isoperistaltic stomach tube. Subjectives and Method: a retrospective descriptive study was carried out on 94 patients with esophageal plastic surgery with isoperistaltic gastric tube at Department of Digestive Surgery, Viet Duc Hospital from January 1994 to June 2006. Results: among 94 patients of the study: 95 males (96.0%) and 4 women (4.0%). Mean age was 54.2 \ufffd?9.0. 98 cases was esophageal cancer (99%), 1 case of benign esophageal narrow due to scarring burns (1%). 31 cases of esophageal plasties with small stomach tube (31.3%), 68 cases of esophageal plasties with a large stomach tube (68.7%). The end-to-side anastomosis was done 95 times (96%), end-to-end anastomosis was done 4 times (4%). There were four deaths. 7 anastomotic leakage (7.1%), but not fatal. The postoperative complications included: 9 cases of respiratory complications (9.1%), 1 case of hypo-diaphragm abces (1%), 7 cases of incision infection (7%). 8 cases of anastomotic narrow (8.4%). 94 patients with normal stomach circulation (98.9%). 88 patients with normal eating (92.6%). Conlussions: the esophageal plastic surgery with isoperistaltic gastric tube was a safe method, with low rates of mortality, anastomotic leakage. Most patients with eating backed to normal.
Esophagoplasty ;

Background: esophagoplasty with transverse colon is often used for benign esophageal diseases. In esophageal cancer, esophagoplasty with transverse colon is applied when the colon can not be used or in gastric bypass surgery, without removing tumor. Objectives: to evaluate the results of esophagoplasty with transverse colon in the treatment of some disorders of esophagus. Subjectives and Method: a retrospective descriptive study was carried out on 63 patients who with transverse colon from January 1982 to December 2006, including 46 cases of esophageal scar due to chemical induced esophageal burn, 14 cases of esophageal cancer, 1 case of esophageal narrow after failed surgery of cardia contraction, 1 case of 2nd stage esophagoplasty after surgery for esophageal injury and 1 case due to failure of surgery for congenital esophageal atrophy. Results: No postoperative mortality. Early postoperative complications included: 17 cases of anastomotic leakage (26.9%). No cases of colon graft necrosis. Narrow anastomotis occurred in 7 cases (11.1%). Inflammation of colon graft due to esophageal reflux in 3 cases (4.8%). The mean survival time of 11 esophageal cancer patients who had esophagoplasty, not removing tumors was 4.6 months (3-7 months). Conclussion: esophagoplastic surgery with transverse colon did not cause postoperative mortality, the rate of neck anastomotic leakage was relatively high and this rate has declined in recent years. After the surgery, the most patients had good functional results.
Esophagoplasty ;

Boerhaave's syndrome has the worst prognosis of the esophageal perforation, despite the advancement in the treatment of esophageal perforation due to the development of ICU care and antibiotics. There were controversies in the treatment of esophageal perforation when diagnosed after 24hrs. From 1995 to 2000, we performed a buttressed primary repair and mediastinal drainage in 6 Boerhaave's syndrome patients among 13 esophageal perforation patients. Two patients died(33%). They died because of pneumonia, ARDS and sepsis on 38th, 39th post-operative day respectively. Two patients had leak at the site of repair which was treated completely with conservative treatment. We report on the result of a buttressed primary repair and mediastinal drainage for 6 Boerhavve's syndrome patients.
Anti-Bacterial Agents ; Drainage ; Esophageal Perforation ; Esophagoplasty ; Humans ; Pneumonia ; Prognosis ; Sepsis

We reviewed the records of 25 patients who were re-operated upon after primary repair of esophageal atresia with or without fistula at the Department of Pediatric Surgery, Seoul National University Children's Hospital, from January 1997 to March 2007. Types of the esophageal atresia anomalies were Gross type A in 5 patients, C in 18, and E in 2. The indications for re-operation were anastomosis stricture (n = 14), tracheo-bronchial remnant (n = 4), persistent anastomosis leakage (n = 3), recurrent tracheo-esophageal fistula (n = 2) and esophageal web (n = 2). The interval between primary and secondary surgery was from 48 days to 26 years 5 months (mean: 2 years and 4 months). Four patients required a third operation. The interval between the second and third operation was between 1 year 1 month and 3 year 10 month (mean: 2 years 5 months). Mean follow up period after last operation was 35 months (1 years-8 years 6 months). The secondary surgery was end-to-end esophageal anastomosis in 15, esophagoplasty in 5, gastric tube replacement in 5. After secondary operation, 6 patients had anastomosis stricture (4 patients were relieved of the symptoms by balloon dilatation, 2 patients underwent tertiary operation). Five patients had leakage (sealed on conservative management in all). Two patients had recurrent tracheo-esophagel fistula (1 patient received chemical cauterization and 1 patient underwent tertiary operation). Currently, only one patient has feeding problems. There were no mortalities. Secondary esophageal surgery after primary surgery for esophageal atresia was effective and safe, should be positively considered when complications do not respond to nonoperative therapy.
Cautery ; Constriction, Pathologic ; Dilatation ; Esophageal Atresia* ; Esophagoplasty ; Fistula ; Follow-Up Studies ; Humans ; Mortality ; Seoul

Esophagoplasty ; methods ; Esophagus ; surgery ; Humans ; Reconstructive Surgical Procedures ; methods ; Stomach ; anatomy & histology ; surgery

Free jejunum has always been a good choice for circumferential hypopharynx and cervical esophagus reconstruction with a low complication rate. Although more and more flaps were used in recent years, free jejunum is still considered as the first choice for such defect.
Esophagoplasty ; Esophagus ; surgery ; Humans ; Hypopharynx ; surgery ; Jejunum ; surgery ; Neck ; surgery ; Reconstructive Surgical Procedures ; Surgical Flaps

Cervical esophageal carcinoma is rare, the lack of early clinical manifestations, early diagnosis is difficult, easily missed or misdiagnosed, especially at present for the method of repairing defect of cervical esophagus cancer after operation. In many mainstream, the repair methods with free jejunum, gastric pull up, and anterolateral thigh flap freeforearm flap. We used the platysma skin flap to repair of cervical esophagus defect which is worthy of reference,report as follows now.
Carcinoma ; surgery ; Esophageal Neoplasms ; surgery ; Esophagoplasty ; Humans ; Myocutaneous Flap ; Neck ; Skin

The advantages of lymph node dissection through total laparoscopic total gastrectomy (TLTG) seem to be more and more accepted by the academic community. However, reconstruction of digestive tract is challenging and remains a focus of debate and research. Which way is better for esophagojejunostomy, circular stapler or linear stapler,remains to be answered. The authors believe that, under the conditions of existing anastomosis instruments, using of linear stapler for esophagojejunal side-to-side anastomosis may be the most common choice, but it must be used with strict indications, because there are still many problems to be solved. It is believed that with the breakthrough in the development of the circular stapler suitable for esophagojejunostomy in TLTG, the application of circular stapler for digestive tract reconstruction will become the mainstream again in future. Thus, the current routine clinical practice of TLTG should be cautious and the surgical indications should be strictly evaluated.
Humans ; Laparoscopy ; Stomach Neoplasms/pathology* ; Anastomosis, Surgical ; Esophagoplasty ; Gastrectomy ; Retrospective Studies

The esophageal jejunum anastomosis of the digestive tract reconstruction techniques in laparoscopic total gastrectomy includes two categories: circular stapler anastomosis techniques and linear stapler anastomosis techniques. Circular stapler anastomosis techniques include manual anastomosis method, purse string instrument method, Hiki improved special anvil anastomosis technique, the transorally inserted anvil(OrVil(TM)) and reverse puncture device technique. Linear stapler anastomosis techniques include side to side anastomosis technique and Overlap side to side anastomosis technique. Esophageal jejunum anastomosis technique has a wide selection of different technologies with different strengths and the corresponding limitations. This article will introduce research progress of laparoscopic total gastrectomy esophagus jejunum anastomosis from both sides of the development of anastomosis technology and the selection of anastomosis technology.
Anastomosis, Surgical ; Digestive System Surgical Procedures ; Esophagectomy ; Esophagoplasty ; Esophagus ; Gastrectomy ; Humans ; Jejunoileal Bypass ; Jejunum ; Laparoscopy ; Reconstructive Surgical Procedures ; Stomach Neoplasms

OBJECTIVETo summarize the experience of applying gastric tube esophagoplasty for complicated diseases of esophagus in children and the short-middle-term efficacy.

METHODSA retrospective and observational case series study was performed.

INCLUSION CRITERIA(1) burn length of esophagus > 2 cm, multisegmental or extensive esophageal scar stenosis, and about 6 months after burn; (2) longitudinal diameter of esophageal tumor > 2 cm, or esophagus considered as impossible to reserve;(3) Severe esophageal fistula with diameter > 2 cm, or relapse again after ≥3 times of repair; (4) Tracheal cartilaginous esophageal heterotopia with a length of >2 cm or no end to end anastomosis after removal of the esophageal lesion.

EXCLUSION CRITERIApatients with severe cardiopulmonary insufficiency, or poor prognosis of gastric primary disease; the gastric volume did not allow long enough gastric tube; the parents did not accept the surgery. According to above criteria, 36 children with complicated diseases of esophagus who underwent gastric tube esophagoplasty at Department of Thoracic Surgery, Guangzhou Women and Children's Medical Center from March 2010 to June 2017 were enrolled into this study. Among 36 children, 27 were with corrosive strictures of esophagus, 5 with esophageal tumor, 3 with severe esophageal fistula, and 1 with tracheal cartilaginous esophageal heterotopia. Above-mentioned 27 cases with corrosive strictures of esophagus underwent gastric tube esophagoplasty via retrosternal route with preservation of the original esophagus. The other 9 cases underwent resection for esophageal lesion and gastric tube esophagoplasty via prevertebral route. The construction of gastric tube was as follows: the stomach was cut along the lesser curvature from pylorus to cardia and fundus of stomach with stapler, making the diameter of the gastric tube equal to pylorus. Operative time, intra-operative bleeding, time of mechanical ventilation, anastomotic leakage, anastomotic stricture were observed. The postoperative short-middle-term growth presentation of children was evaluated according to CDC 2000 children growth evaluation table(2 to 20 years).

RESULTSAll the 36 children survived their operations successfully. Nine cases underwent esophagectomy for lesion esophagus and the other 27 cases received preservation of original esophagus. Average time of postoperative mechanical ventilation was 8 (4-20) hours. Three cases developed anastomotic leakage and were healed after one week. Eight cases developed anastomotic stricture and resumed normal diet after balloon expansion. The patients were followed up from 6 months to 7 years. Five cases were found to have esophageal cyst 4-8 months after the operation, and received resection. One children with infantile esophageal fibrosarcoma recurred 3 weeks after the operation and died 2 weeks later because the family abandoned the treatment. The quality of life of 35 cases was improved significantly. Short-middle-term body height and weight in 85.7%(30/35) children met basically the criteria of CDC 2000 children growth evaluation table.

CONCLUSIONGastric tube esophagoplasty can effectively treat the children with complicated esophagus diseases with good short-middle-term efficacy, and is a recommended esophageal replacement surgery.

Burns ; surgery ; Child ; Esophageal Diseases ; surgery ; Esophageal Stenosis ; surgery ; Esophagoplasty ; Female ; Humans ; Quality of Life ; Retrospective Studies ; Stomach