Gao-Li Liu1, Xin Wang2, Hai-Feng Hu1, Zhi-Hao Nie1, Wei Ming3, Xing-Lin Long1, Wen-Han Zhang1, Xing-Hua Zhang1, Jie Huang1, Wan-Li Jiang4, Song-Ping Xie5. 1. Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Hubei Province, Jiefang Road 238, Wuhan City, 430060, People's Republic of China. 2. Department of Thoracic Surgery, Nanyang Centre Hospital, Gongnong Road 312, Henan Province, 473000, Nanyang City, People's Republic of China. 3. Department of Thoracic Surgery, Yangxin County, Yangxin People's Hospital, Hubei Province, Ruxue Road 81, Huangshi City, 435200, People's Republic of China. 4. Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Hubei Province, Jiefang Road 238, Wuhan City, 430060, People's Republic of China. 418319069@qq.com. 5. Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Hubei Province, Jiefang Road 238, Wuhan City, 430060, People's Republic of China. songping0428@126.com.
Abstract
BACKGROUND: Oesophageal replacement by colonic interposition remains a major challenge due to its complexity and high incidence of complications; here we applied the two-stage operation strategy to oesophageal replacement by colonic interposition in high-risk oesophageal cancer patients following gastrectomy. METHODS: We performed a retrospective analysis on the data of patients with a history of distal gastrectomy who underwent one-stage and two-stage oesophageal replacement by colonic interposition from February 2012 to February 2020, and explored the relationship between the staging strategy and postoperative outcomes. RESULTS: The clinical data of 93 patients were collected and analysed. There were no significant differences in the patients' characteristics between the two groups (all p > 0.05), except for comorbidities and Charlson Comorbidity Index (all p < 0.05). The Clavien-Dindo score between the two groups was also not significantly different (p > 0.05). The logistic regression models revealed that patients who had received preoperative therapy had a higher Clavien-Dindo score (p < 0.05), but the stage strategy did not (p > 0.05). CONCLUSIONS: The two-stage operation is feasible in high-risk patients who need to undergo colonic interposition for oesophageal replacement. At the same time, it lowers the technical threshold of colonic interposition for oesophageal replacement, increasing this surgical technique's acceptability.
BACKGROUND: Oesophageal replacement by colonic interposition remains a major challenge due to its complexity and high incidence of complications; here we applied the two-stage operation strategy to oesophageal replacement by colonic interposition in high-risk oesophageal cancer patients following gastrectomy. METHODS: We performed a retrospective analysis on the data of patients with a history of distal gastrectomy who underwent one-stage and two-stage oesophageal replacement by colonic interposition from February 2012 to February 2020, and explored the relationship between the staging strategy and postoperative outcomes. RESULTS: The clinical data of 93 patients were collected and analysed. There were no significant differences in the patients' characteristics between the two groups (all p > 0.05), except for comorbidities and Charlson Comorbidity Index (all p < 0.05). The Clavien-Dindo score between the two groups was also not significantly different (p > 0.05). The logistic regression models revealed that patients who had received preoperative therapy had a higher Clavien-Dindo score (p < 0.05), but the stage strategy did not (p > 0.05). CONCLUSIONS: The two-stage operation is feasible in high-risk patients who need to undergo colonic interposition for oesophageal replacement. At the same time, it lowers the technical threshold of colonic interposition for oesophageal replacement, increasing this surgical technique's acceptability.
Authors: Donald E Low; Derek Alderson; Ivan Cecconello; Andrew C Chang; Gail E Darling; Xavier Benoit DʼJourno; S Michael Griffin; Arnulf H Hölscher; Wayne L Hofstetter; Blair A Jobe; Yuko Kitagawa; John C Kucharczuk; Simon Ying Kit Law; Toni E Lerut; Nick Maynard; Manuel Pera; Jeffrey H Peters; C S Pramesh; John V Reynolds; B Mark Smithers; J Jan B van Lanschot Journal: Ann Surg Date: 2015-08 Impact factor: 12.969
Authors: Min Hye Im; Jong Won Kim; Whan Sik Kim; Jie-Hyun Kim; Young Hoon Youn; Hyojin Park; Seung Ho Choi Journal: J Gastric Cancer Date: 2014-03-31 Impact factor: 3.720