Comparison of outcomes of pedicled jejunal and colonic conduit for esophageal reconstruction.
Esophageal cancer
Gastric remnant
Pedicle jejunum
Postoperative
Reconstruction
Journal
BMC surgery
ISSN: 1471-2482
Titre abrégé: BMC Surg
Pays: England
ID NLM: 100968567
Informations de publication
Date de publication:
16 Jul 2020
16 Jul 2020
Historique:
received:
19
02
2020
accepted:
29
06
2020
entrez:
18
7
2020
pubmed:
18
7
2020
medline:
19
12
2020
Statut:
epublish
Résumé
At present, the gastric tube is the first choice for esophageal reconstruction after esophagectomy for various benign and malignant diseases. However, when the stomach is not available, a pedicled jejunum or colon is used to reconstruct the esophagus. The present study aimed to compare the postoperative outcomes and quality of life of patients receiving jejunal and colonic conduits. In the present retrospective study, the clinical data of 71 patients with esophageal carcinoma, who received jejunal reconstruction (jejunum group, n = 34) and colonic reconstruction (colon group, n = 37) from 2005 to 2015, were compared. Compared with the colon group, the jejunum group had a lower incidence of postoperative anastomotic leakage, lesser duration of postoperative drainage, and faster recovery. Furthermore, the scores were better in the jejunum group than in the colon group, in terms of short-term overall quality of life, physical function and social relationships. Moreover, the jejunal group had a significantly lower frequency of pH < 4 simultaneous reflux time > 5 min (N45) and the longest reflux time (LT) at 24 weeks after surgery. In esophageal cancer, when gastric tube construction is not feasible, a pedicled jejunum may be preferred over a colonic conduit due to lower incidence of acid reflux, anastomotic leakage and higher postoperative short-term quality of life, and rapid postoperative recovery.
Sections du résumé
BACKGROUND
BACKGROUND
At present, the gastric tube is the first choice for esophageal reconstruction after esophagectomy for various benign and malignant diseases. However, when the stomach is not available, a pedicled jejunum or colon is used to reconstruct the esophagus. The present study aimed to compare the postoperative outcomes and quality of life of patients receiving jejunal and colonic conduits.
METHODS
METHODS
In the present retrospective study, the clinical data of 71 patients with esophageal carcinoma, who received jejunal reconstruction (jejunum group, n = 34) and colonic reconstruction (colon group, n = 37) from 2005 to 2015, were compared.
RESULTS
RESULTS
Compared with the colon group, the jejunum group had a lower incidence of postoperative anastomotic leakage, lesser duration of postoperative drainage, and faster recovery. Furthermore, the scores were better in the jejunum group than in the colon group, in terms of short-term overall quality of life, physical function and social relationships. Moreover, the jejunal group had a significantly lower frequency of pH < 4 simultaneous reflux time > 5 min (N45) and the longest reflux time (LT) at 24 weeks after surgery.
CONCLUSION
CONCLUSIONS
In esophageal cancer, when gastric tube construction is not feasible, a pedicled jejunum may be preferred over a colonic conduit due to lower incidence of acid reflux, anastomotic leakage and higher postoperative short-term quality of life, and rapid postoperative recovery.
Identifiants
pubmed: 32677925
doi: 10.1186/s12893-020-00810-y
pii: 10.1186/s12893-020-00810-y
pmc: PMC7364600
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
156Subventions
Organisme : Medjaden Academy & Research Foundation for Young Scientists
ID : MJA20180926
Références
Surgeon. 2015 Aug;13(4):187-93
pubmed: 24507388
Ann Surg. 1946 May;123(5):819-34
pubmed: 17858777
Gen Thorac Cardiovasc Surg. 2014 Oct;62(10):627-34
pubmed: 24917205
Eur J Cancer. 2003 Jul;39(10):1384-94
pubmed: 12826041
J Surg Oncol. 2017 May;115(6):729-737
pubmed: 28194797
Dis Esophagus. 2008;21(2):132-8
pubmed: 18269648
J Thorac Dis. 2014 May;6 Suppl 3:S333-40
pubmed: 24876939
Dis Esophagus. 2017 Dec 1;30(12):1-7
pubmed: 28881892
World J Surg. 2005 Jul;29(7):841-8
pubmed: 15951920
Thorac Cardiovasc Surg. 2013 Sep;61(6):460-3
pubmed: 23344774
Ann Surg. 2016 Apr;263(4):738-44
pubmed: 26501699
Ann Thorac Surg. 2012 Oct;94(4):1104-11; discussion 1111-3
pubmed: 22939245
Surg Clin North Am. 2012 Oct;92(5):1287-97
pubmed: 23026282
Ann Thorac Surg. 1993 Jun;55(6):1386-92; discussion 1392-3
pubmed: 8512386
Asian Cardiovasc Thorac Ann. 2012 Oct;20(5):600-3
pubmed: 23087311
CA Cancer J Clin. 2016 Mar-Apr;66(2):115-32
pubmed: 26808342
Am J Gastroenterol. 1998 Jan;93(1):11-5
pubmed: 9448165
BMJ. 2013 Jun 18;346:f3959
pubmed: 23778287
Gen Thorac Cardiovasc Surg. 2016 Aug;64(8):457-63
pubmed: 27234222
Dig Dis Sci. 2018 Mar;63(3):703-712
pubmed: 29372475
J Clin Epidemiol. 1997 Apr;50(4):441-50
pubmed: 9179103
World J Surg. 2005 Jun;29(6):700-7
pubmed: 16078126
Dis Esophagus. 2017 Dec 1;30(12):1-11
pubmed: 28881882