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<Review> Optimal reconstruction methods with a gastric substitute after esophagectomy
https://kindai.repo.nii.ac.jp/records/10563
https://kindai.repo.nii.ac.jp/records/10563965bde5f-169c-44ca-b0ec-68426b58d30e
| 名前 / ファイル | ライセンス | アクション |
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AA0050842-20131200-0069.pdf (629.0 kB)
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| Item type | ☆一般雑誌記事 / Article(1) | |||||||||
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| 公開日 | 2014-05-27 | |||||||||
| タイトル | ||||||||||
| タイトル | <Review> Optimal reconstruction methods with a gastric substitute after esophagectomy | |||||||||
| 言語 | en | |||||||||
| 著者 |
Yasuda, Takushi
× Yasuda, Takushi
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| 言語 | ||||||||||
| 言語 | eng | |||||||||
| キーワード | ||||||||||
| 主題 | Esophageal cancer, esophagectomy, reconstruction, stomach, gastric tube, anastomosis, route | |||||||||
| 資源タイプ | ||||||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||||||
| 資源タイプ | article | |||||||||
| 著者 所属 | ||||||||||
| 値 | Division of Esophago-Gastric Surgery, Department of Kinki University Faculty of Medicine | |||||||||
| 著者所属(翻訳) | ||||||||||
| 値 | Kinki University | |||||||||
| 版 | ||||||||||
| 出版タイプ | VoR | |||||||||
| 出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||||||
| 出版者 名前 | ||||||||||
| 出版者 | Kinki University Medical Association | |||||||||
| 書誌情報 |
en : ACTA MEDICA KINKI UNIVERSITY 巻 38, 号 2, p. 69-78, 発行日 2013-12-01 |
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| ISSN | ||||||||||
| 収録物識別子タイプ | ISSN | |||||||||
| 収録物識別子 | 03866092 | |||||||||
| 抄録 | ||||||||||
| 内容記述タイプ | Abstract | |||||||||
| 内容記述 | [Abstract] The preferred organ for reconstruction after esophagectomy is the stomach, but the procedures vary even for a gastric pull-up reconstruction. In this article, I review the major reports on the most popular procedures, specifically in relation to the following three aspects ofthe surgeries and examine the optimal gastric reconstruction technique at present. Size of gastric substitute : Compared with whole-stomach (WS) reconstruction, gastric tube (GT) reconstruction tended to have comparable incidence of anastomotic leakage, less chest discomfort, and a lower incidence of reflux esophagitis. As for physiological function of the gastric substitute, opinions differed as to the value of each : the WS preserves the entire gastric wall vascular network and has a larger capacity, enabling the patient to take sufficient calories by eating more meals, while the smallervolume and lower compliance of the gastric tube wall provides a rapid increase in intragastric pressure that facilitates gastric emptying after food intake and lowers compression of the lung and heart, thereby minimizing the ability of intrathoracic negative pressure to cause duodenogastric reflux. In GT, longer length and complete clearance of the lymph nodes between the subcardia and gastric angle are also great advantages for tension-free anastomosis and curativity. This review suggests that the GT is a superior esophageal substitute. Reconstruction route : Comparing the posteriormediastinal (PM) and retrosternal (RS) routes, PM is shorter, which is an advantage for tension-free anastomosis, but is susceptible to intrathoracic negative pressure and carries a risk of secondary dysphagia due to locoregional recurrence. On the other hand, the RS route facilitates irradiation of locoregional recurrence with less fear of adverse effects on the gastric conduit. Some authors reported the RS route had a higher rate of anastomotic leakage, although this review finds the rate is likely to be similar between the two routes. At present, RS is recommended in the palliative setting.Level of anastomosis : Comparison of cervical anastomosis (CA) and thoracic anastomosis (TA) revealed that CS enabled a 1.5 to 2.5 cm longer resection of the proximal esophagus, which was reported to decrease the risk of anastomotic recurrence. However, recent studies showed comparable survival rates for CA and TA groups. No significant difference was observed in the anastomotic leakage rate between the two groups. Currently, esophageal reconstruction methods after esophagectomy should be determined on an individual basis, after careful consideration of the merits and risks of each procedure and technique. | |||||||||
| 資源タイプ | ||||||||||
| 内容記述タイプ | Other | |||||||||
| 内容記述 | Article | |||||||||
| フォーマット | ||||||||||
| 内容記述タイプ | Other | |||||||||
| 内容記述 | application/pdf | |||||||||
