Modern methods of esophageal reconstruction in case of its resection and Extirpation

Authors

  • Y. V. Shaprynskyi M. Pyrohov Vinnytsia National Medical University

DOI:

https://doi.org/10.11603/2414-4533.2019.4.10718

Keywords:

esophageal stricture, therapeutic approach, esophageal reconstruction method

Abstract

The aim of the work: the article is devoted to the problem of improving the efficiency of surgical treatment in patients with corrosive strictures of the esophagus by choosing optimal esophageal reconstruction method in case of its resection and extirpation.
Materials and Methods. The results of examination and treatment of 177 patients with corrosive esophageal strictures of various etiology were reviewed in the study. All patients underwent esophageal reconstruction. Logistic regression method was used to predict the development of complications. In high risk of complications (over 70 %), the patients underwent minimally invasive treatment. In average risk of complications (40–70 %), the patients underwent intensive infusion therapy prior to esophagoplasty at the intensive care unit. In low risk of complications (less than 40 %), the patients underwent reconstructive surgery with proper preoperative preparation at the surgical department.

Results and Discussion. The developed algorithm was the following: in the presence of strictures less than 3.0 cm in length, esopha­goplasty using the patients’ own tissues was carried out. The strictures of more than 3.0 cm in length and the presence of esophageal cancer were indications for esophagoplasty by autograft. In high strictures, colon esophagoplasty was performed according to the developed method of the clinic, as well as in cases of impossibility to use the stomach. In middle and low esophageal strictures, esopha­goplasty was performed by gastric tube according to the proposed method; otherwise, colon esophagoplasty was performed. Esopha­goplasty by ileocecal segment was developed for cases when the stomach and the colon could not be used as a transplant. The use of proposed algorithm for the choice of esophageal reconstruction method has led to significant decrease in the level of complications associated with esophageal-organ anastomoses, duration of hospital stay, duration of  postoperative period as well as postoperative mortality rate (from 6.0 % to 2.6 %).

References

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Published

2020-01-11

How to Cite

Shaprynskyi, Y. V. (2020). Modern methods of esophageal reconstruction in case of its resection and Extirpation. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (4), 95–99. https://doi.org/10.11603/2414-4533.2019.4.10718

Issue

No. 4 (2019)

Section

EXPERIENCE OF WORK

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