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Oblique conformal anastomosis decreased the risks of cervical anastomotic leakage after totally minimally invasive esophagectomy.
Guo, Jinyang; Xu, Yanzhao; Huang, Chao; Wang, Mingbo; Zhang, Fan; Liu, Zhao; Li, Zhenhua; Lv, Huilai; Tian, Ziqiang.
Afiliación
  • Guo J; Emergency Department, The Affiliated Hospital of Chengde Medical University, China.
  • Xu Y; Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, China.
  • Huang C; Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, China.
  • Wang M; Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, China.
  • Zhang F; Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, China.
  • Liu Z; Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, China.
  • Li Z; Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, China.
  • Lv H; Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, China.
  • Tian Z; Fourth Hospital of Hebei Medical University, China. Electronic address: tianziqiang@hebmu.edu.cn.
Asian J Surg ; 47(8): 3478-3484, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38604851
ABSTRACT

OBJECTIVE:

To investigate the effectiveness of the original oblique conformal anastomosis presented in this research in reducing the incidence of cervical anastomotic leak after performing totally minimally invasive esophagectomy (TMIE).

METHODS:

The esophagus and stomach of 27 fresh pigs, termed the esophagogastric model, were used to simulate human esophagogastric organs for this study's in vitro experimental objectives. Nine esophagogastric models of similar weight were divided into three groups. Esophagogastrostomy with circular-stapled end-to-side anastomosis was performed. A tension gauge was used to pull the anastomosis, and the tension at which anastomotic leakage occurred was recorded. Furthermore, a retrospective assessment of 539 patients who underwent TMIE was conducted to analyze the influencing factors of cervical anastomotic leakage.

RESULTS:

Experiments on the esophagogastric models showed a higher fracture strength of oblique conformal anastomosis than that of conventional anastomosis (F2,18 = 40.86, P < 0.05), which was associated with a lower incidence of cervical anastomotic leakage (X2 = 9.0260, P = 0.0027). Retrospective analysis of 539 esophageal cancer patients who underwent TMIE showed that in contrast to conventional anastomosis, oblique conformal anastomosis was an independent protective factor against cervical anastomotic leakage (P = 0.0462, OR = 0.5872, 95% CI = 0.3497-0.9993).

CONCLUSION:

Oblique conformation anastomosis was stronger and involved a more prominent reduced risk of cervical anastomotic leakage than conventional anastomosis after TMIE.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estómago / Neoplasias Esofágicas / Anastomosis Quirúrgica / Esofagectomía / Procedimientos Quirúrgicos Mínimamente Invasivos / Esófago / Fuga Anastomótica Límite: Aged / Animals / Female / Humans / Male / Middle aged Idioma: En Revista: Asian J Surg Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Países Bajos
Texto completo
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Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estómago / Neoplasias Esofágicas / Anastomosis Quirúrgica / Esofagectomía / Procedimientos Quirúrgicos Mínimamente Invasivos / Esófago / Fuga Anastomótica Límite: Aged / Animals / Female / Humans / Male / Middle aged Idioma: En Revista: Asian J Surg Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Países Bajos