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1 . 2022

Delayed esophageal replacement by intestinal interposition after esofagogastrectomy

Abstract The present report focuses on the successful delayed repeated esophagoplasty by using pedicle jejunal graft. The patient with adenocarcinoma of the gastroesophageal junction (GEJ) Siewert III underwent transhiatal esophagogastrectomy with colon interposition. There was detected the primary esophagoplasty failure in the early postoperative period because of the graft necrosis, so the primary esophagoplasty wasn’t completed. The patient with the stable disease underwent a successful delayed repeated jejunal pedicle graft reconstruction of the esophagus in 10 months after primary surgery, which provided a good quality of life.

Keywords:adenocarcinoma of the gastroesophageal junction; esophagectomy, gastrectomy; esophagogastrectomy; esophagoplasty; the lack of the organ reserve for esophagoplasty; incompleted esophagoplasty; repeated esophageal reconstruction; Siewert type

Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Ruchkin D.V., Nazariev P.I., Okonskaya D.E., Savelieva V.A. Delayed esophageal replacement by intestinal interposition after esofagogastrectomy. Clinical and Experimental Surgery. Petrovsky Journal. 2022; 10 (1): 149–58. DOI: https://doi.org/10.33029/2308-1198-2022-10-1-149-158  (in Russian)

References

1. Buas M.F., Vaughan T.L. Epidemiology and risk factors for gastroesophageal junction tumors: understanding the rising incidence of this disease. Semin Radiat Oncol. 2013; 23 (1): 3–9. DOI: https://doi.org/10.1016/j.semradonc.2012.09.008  PMID: 23207041; PMCID: PMC3535292.

2. Zhang Y. Epidemiology of esophageal cancer. World J Gastroenterol. 2013; 19 (34): 5598–606. DOI: https://doi.org/10.3748/wjg.v19.i34.5598  PMID: 24039351; PMCID: PMC3769895.

3. Davydov M.I., Turkin I.N., Stilidi I.S., Polotsky B.E., Ter-Ovanesov M.D. Cardioesophageal cancer: classification, surgical tactics, main prognostic factors. Bulletin of N.N. Blokhin RAMS. 2003. No. 1. S. 82–89. 2003; (1): 82–9. (in Russian)

4. Berdov B.A., Mardynsky Yu.S., Skoropad V.Yu. Long-term results of a clinical study of the effectiveness of pre- and intraoperative radiation therapy in the combined treatment of gastric cancer // Issues of Oncology. 2006; (5): 515–20. (in Russian)

5. Lerut T., Coosemans W., Decker G., De Leyn P., Nafteux P., Van Raemdonck D. Cancer of the esophagus and gastro-esophageal junction: potentially curative therapies. Surg Oncol. 2001; 10 (3): 113–22. DOI: https://doi.org/10.1016/s0960-7404(01)00027-5  PMID: 11750230.

6. Vrouenraets B.C., van Lanschot J.J. Extent of surgical resection for esophageal and gastroesophageal junction adenocarcinomas. Surg Oncol Clin N Am. 2006; 15 (4): 781–91. DOI: https://doi.org/10.1016/j.soc.2006.07.008  PMID: 17030273.

7. Birkmeyer J.D., Sun Y., Wong S.L., Stukel T.A. Hospital volume and late survival after cancer surgery. Ann Surg. 2007; 245 (5): 777–83. DOI: https://doi.org/10.1097/01.sla.0000252402.33814.dd  PMID: 17457171; PMCID: PMC1877074.

8. Davydov M.I., Ter-Ovanesov M.D. Cancer of the proximal stomach: modern classification, tactics of surgical treatment, prognostic factors // BC. 2008; (13): 914–20. (in Russian)

9. Pedrazzani C., de Manzoni G., Marrelli D., Giacopuzzi S.,  Corso G., Minicozzi A.M., et al. Lymph node involvement in advanced gastroesophageal junction adenocarcinoma. J Thorac Cardiovasc Surg. 2007; 134 (2): 378–85. DOI: https://doi.org/10.1016/j.jtcvs.2007.03.034  PMID: 17662776.

10.   Ruchkin D.V., Okonskaya D.E., Yan M.N., et al. Esophagoplasty with a combined visceral graft // Bulletin of Experimental and Clinical Surgery. 2020; 13 (2): 125–34. DOI: https://doi.org/10.18499/2070-478X-2020-13-2-125-134  (in Russian)

11.   Bakirov A.A. Total esophagoplasty for strictures of the esophagus // Bulletin of Surgery. 2001; (1): 53–7. (in Russian)

12.   Chikinev Yu.V., Korobeinikov A.V., Sudovykh I.E., Raja H.  Results of reconstructive and restorative operations on the esophagus // Proceedings of the 3rd Moscow International Conference on Thoracic Surgery, January 17–19, 2005. Moscow, 2005: 318–22. (in Russian)

13.   Domreis J.S., Jobe B.A., Aye R.W., Deveney K.E., Sheppard B.C., Deveney C.W. Management of long-term failure after colon interposition for benign disease. Am J Surg. 2002; 183 (5): 544–6. DOI: https://doi.org/10.1016/s0002-9610(02)00827-9  PMID: 12034389.

14.   Predescu D., Constantinoiu S. Probleme şi dificultăţi ridicate de reconstrucţia esofagiană [Problems and difficulties in patients with esophageal reconstruction]. Chirurgia (Bucur). 2002; 97 (2): 187–201. PMID: 12731230. (in Romanian)

15.   Popov V.I., Reshetov A.I. On the causes of complications after presternal plastic surgery of the esophagus by the stomach and measures to prevent them // Clinical Surgery. 1967; (10): 21–5. (in Russian)

16.   Zavgorodnii L.G., Belozertsev A.M., Besedin A.E., Smirnova N.N. Surgical rehabilitation for cicatricial obstruction of the esophagus // General and emergency surgery: Republican interdepartmental collection Kiev: Health, 1985: 85–90. (in Russian)

17.   Stolyarov V.I., Gorzov P.P., Marinichev V.L. et al. Surgical and radiation treatment of esophageal cancer // Problems of Oncology. 1997; 43 (2): 161–3. (in Russian)

18.   DiPierro F.V., Rice T.W., DeCamp M.M., Rybicki L.A., Blackstone E.H. Esophagectomy and staged reconstruction. Eur J Cardiothorac Surg. 2000; 17 (6): 702–9. DOI: https://doi.org/10.1016/s1010-7940(00)00408-5   PMID: 10856863.

19.   Roman L.D., Karachun A.M., Shostka K.G., Kostyuk I.P. Methods of reconstruction of the esophagus // Practical oncology. 2003; 4 (2): 99–107. (in Russian)

20.   Popov V.I., Zhupan V.F. On the prevention of intestinal graft necrosis during esophagoplasty. Clinical Surgery. 1966; (9): 15–6. (in Russian)

21.   Kolomiichenko M.I. Reconstructive surgery of the esophagus. Kiev, 1967: 410 p. (in Russian)

22.   Vantsyan E.N., Toshchakov R.A. Treatment of burns and cicatricial narrowing of the esophagus. Moscow, 1971: 260 p. (in Russian)

23.   Chernousov A.F., Ruchkin D.V., Chernousov F.A., Balalykin D.A. Diseases of the artificial esophagus. Moscow, 2008. (in Russian)

24.   Volkolakov Ya.V. Longitudinal dissection of the sternum in the creation of the retrosternal esophagus from the intestine. Khirurgiya. 1963; (11): 47–50. (in Russian)

25.   Stolyarov V.I., Gorzov P.P., Musukaev Kh.M. Reoperations on the artificial esophagus // Issues of practical medicine: Proceedings of the scientific and practical conference dedicated to the 20-th anniversary of the Department of Surgery No. 3 of the St. Petersburg Medical Academy of Postgraduate Education. St. Petersburg, 1997: 47–8. (in Russian)

26.   Rossetti M. Die operierte Speiserohre. Stuttgart, 1963: 126 p.

27.   Siewert J.R., Stein H.J., Bartels H. Insuffizienzen nach Anastomosen im Bereich des oberen Gastrointestinaltraktes [Anastomotic leaks in the upper gastrointestinal tract]. Chirurg. 2004; 75 (11): 1063–70. DOI: https://doi.org/10.1007/s00104-004-0967-9  PMID: 15517114. (in German)

28.   Peyre C.G., Hagen J.A., DeMeester S.R., Altorki N.K., Ancona E., Griffin S.M., et al. The number of lymph nodes removed predicts survival in esophageal cancer: an international study on the impact of extent of surgical resection. Ann Surg. 2008; 248 (4): 549–56. DOI: https://doi.org/10.1097/SLA.0b013e318188c474  PMID: 18936567.

29.   Vorobey A.V., Chepik D.A., Vizhinis E.I., Makhmudov A.M. The history of the creation of a viable intestinal graft for bypass esophagoplasty. Part II // News of Surgery. 2018; 26 (4): 389–401. DOI. https://doi.org/10.18484/2305-0047.2018.4.389   (in Russian)

30.   Turkyilmaz A., Eroglu A., Aydin Y., Tekinbas C., Muharrem Erol M., Karaoglanoglu N. The management of esophagogastric anastomotic leak after esophagectomy for esophageal carcinoma. Dis Esophagus. 2009; 22 (2): 119–26. DOI: https://doi.org/10.1111/j.1442-2050.2008.00866.x  Epub 2008 Oct 1. PMID: 18847447.

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CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

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