Clinical Trials Study
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World J Gastroenterol. Nov 21, 2014; 20(43): 16282-16286
Published online Nov 21, 2014. doi: 10.3748/wjg.v20.i43.16282
Preventing and localizing esophagogastric anastomosis leakage by sleeve-wrapping of the pedicled omentum
Quan-Xing Liu, Xu-Feng Deng, Bing Hou, Jia-Xin Min, Ji-Gang Dai
Quan-Xing Liu, Xu-Feng Deng, Bing Hou, Jia-Xin Min, Ji-Gang Dai, Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
Author contributions: Dai JG conceived of and designed the study and gave final approval of the manuscript; Liu QX analyzed and interpreted the data and drafted the article; Deng XF, Hou B and Min JX critically revised the article.
Supported by Xinqiao Hospital of the Third Military Medical University
Correspondence to: Ji-Gang Dai, PhD, MD, Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, No. 252, Shapingba District, Chongqing 400037, China. 691057831@qq.com
Telephone: +86-23-68774724 Fax: +86-23-68774724
Received: June 9, 2014
Revised: July 4, 2014
Accepted: July 24, 2014
Published online: November 21, 2014
Abstract

AIM: To develop a technique of sleeve-wrapping the pedicled omentum around the esophagogastric anastomosis for preventing and localizing leakage.

METHODS: This study includes data from 86 patients who were diagnosed with esophageal cancer and underwent the technique of sleeve-wrapping the pedicled omentum around esophagogastric anastomosis after esophagectomy between November 2011 and July 2013. The early complications that occurred during follow-up were analyzed.

RESULTS: Postoperative complications included pulmonary complications (13/86; 15.1%) and abdominal or thoracic wound infection (3/86; 3.5%). Complications that occurred during follow-up included one case of anastomosis leakage (limited by omentum; 1.2%) and five case of anastomosis stricture (5.8%). No deaths occurred. All complications were resolved through traditional treatment. No additional surgery was needed.

CONCLUSION: Sleeve-wrapping of the pedicled omentum around esophagogastric anastomosis after esophagectomy is safe and effective for preventing and localizing anastomosis leakage without increasing anastomosis stricture.

Keywords: Anastomotic leakage, Esophageal cancer, Esophagectomy, Esophagogastrostomy, Pedicled omentum

Core tip: This study describes sleeve-wrapping of the pedicled omentum around esophagogastric anastomosis after esophagectomy to prevent and localize anastomosis leakage for the treatment of esophageal carcinoma. A total of 86 patients with esophageal carcinoma were operated upon with the new anastomosis technique at our institute, and only one patient developed anastomotic leakage, which was limited by the omentum, and successfully cured by conservative treatment. A better understanding of this may provide a good alternative method for anastomosis after esophagogastrectomy of esophageal cancer.