A CLINICAL STUDY OF RECONSTRUCTION BY INTRATHORACIC ANASTOMOSIS AFTER ESOPHAGEAL RESECTION

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  • SATO Koichi
    Department of Surgery. Juntendo Izu Nagaoka Hospital, Juntendo University School of Medicine
  • MAEKAWA Takeo
    Department of Surgery. Juntendo Izu Nagaoka Hospital, Juntendo University School of Medicine
  • HABA Takanori
    Department of Surgery. Juntendo Izu Nagaoka Hospital, Juntendo University School of Medicine
  • YABUKI Kiyotaka
    Department of Surgery. Juntendo Izu Nagaoka Hospital, Juntendo University School of Medicine
  • TSUMURA Hidenori
    Department of Surgery, Koshigaya City Hospital
  • WATANABE Yozo
    Department of Surgery, Koshigaya City Hospital

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Other Title
  • 食道癌切除後の胸腔内吻合による再建術式の検討

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Abstract

Utilities of intrathoracic anastomosis after resection of esophageal cancer were compared with those of conventional procedures of reconstruction. Subjects were 13 cases of intrathoracic anastomosis (ITA), 76 cases of reconstruction through the retrosternal route (RSR), 4 cases of through the antethoracal route (ATR) and 25 cases of posterior mediastinal route (PMR). Duration of the operation in ITA was 354min and volume of bleeding during the operation was 536g. These values were significantly shorter or less than other groups. Rates of anastomotic deficiency in RSR, ATR, and PMR were 32.9, 100, and 36%, respectively, while that in ITA was 0%. Incidences of liver dysfunction and disturbance of the food passage were significantly lower (7.7, 23.1% respectively). Periods of start of food intake and hospital stay after the operation were 11.2 days and 31.3 days respectively which were significantly shorter than those of other three groups.Moreover, volume of food intake was good or mediate in all cases of ITA. Postoperative courses in all cases in ITA were uneventful, and no hospital death was seen. These findings suggest that ITA is useful for esophageal cancers occupied the middle and lower esophagus because it offers less intensity of surgical operation and excellent postoperative results.

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