OUTCOMES OF SUBTOTAL STOMACH RECONSTRUCTION WITH ESOPHAGECTOMY FOR ESOPHAGEAL CANCER: AN ANALYSIS OF ANASTOMOTIC COMPLICATIONS AND POSTOPERATIVE QUALITY OF LIFE

Main Article Content

Fauwaz Fahad Alrashid
Dr. Sanober Baloch
Ahmed Samir Abdelmageed Mohamed Elfiki
Amgad Samir Abdelmageed Mohamed Elfeki
Dr. Atif Hussain

Keywords

Anastomotic Leakage, Oesophagal Surgery, Quality Of Life, Reconstruction, Subtotal Stomach

Abstract

Objective: This retrospective, study aimed to evaluate the safety and feasibility of subtotal stomach (SS) reconstruction with esophagectomy for patients with esophageal cancer (EC), focusing on anastomotic leakage rates and postoperative quality of life (QOL).


Methods: Between January 2012 and September 2023, 320 patients underwent esophagectomy for EC with SS reconstruction. The primary endpoint was the incidence of anastomotic leakage. Secondary endpoints included postoperative morbidities, QOL assessment, and changes in body weight and skeletal muscle mass.


Results: Anastomotic leakage occurred in only two patients (0.67%), while pneumonia was observed in nine patients (3.0%). Fifteen patients (5.0%) experienced anastomotic stenosis necessitating bougienage. Nausea was reported in 11 patients (3.7%), and dumping syndrome in seven patients (2.3%). Dysphagia and early satiety scores were initially elevated post-surgery but gradually improved after six months. Reflux symptom scores showed favorable outcomes. Over five years, there was an average decrease in body weight of -2 ± 3.71 kg (P = .071).


Conclusion: Reconstruction using SS demonstrated a low incidence of anastomotic leakage and favorable postoperative QOL outcomes in patients undergoing EC surgery. This approach holds promise for improving patient outcomes and minimizing complications associated with EC surgery.

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References

1. Aksoyler, D., Ercan, A., Losco, L., Chen, S. H., & Chen, H. C. (2022). Experience in reconstruction of esophagus, epiglottis, and upper trachea due to caustic injuries in pediatric patients and establishment of algorithm. Microsurgery, 42(2), 125-134.
2. Deng, M. C., & Naka, Y. (2007). Mechanical circulatory support therapy in advanced heart failure. World Scientific.
3. Gjeorgjievski, M., Imam, Z., Cappell, M. S., Jamil, L. H., & Kahaleh, M. (2021). A comprehensive review of endoscopic management of sleeve gastrectomy leaks. Journal of Clinical Gastroenterology, 55(7), 551-576.
4. Hosseini, F., Asadi, F., Emami, H., & Ebnali, M. (2023). Machine learning applications for early detection of esophageal cancer: a systematic. Endoscopy, 723, 3.
5. Johnson, G., Hickey, K., Azin, A., Guidolin, K., Shariff, F., Gentles, J., Parapini, M., Guo, R., Ertel, E., & Lenet, T. (2021). 2021 Canadian Surgery Forum.
6. Management of choledocholithiasis following Roux-en-Y gastric bypass: a systematic review and meta-analysis: Virtual, online Sept. 21–24, 2021. In: Canadian Journal of Surgery.
7. Losco, L., Roxo, A. C., Roxo, C. W., de Sire, A., Bolletta, A., Cuomo, R., Grimaldi, L., Cigna, E., & Roxo, C. d. P. (2022). Helix thigh lift. A novel approach to severe deformities in massive weight loss patients. Journal of Investigative Surgery, 35(3), 620-626.
8. McClave, S. A., Sexton, L. K., Spain, D. A., Adams, J. L., Owens, N. A., Sullins, M. B., Blandford, B. S., & Snider, H. L. (1999). Enteral tube feeding in the intensive care unit: factors impeding adequate delivery. Critical care medicine, 27(7), 1252-1256.
9. Misra, S., Bhattacharya, S., Saravana Kumar, S., Nandhini, B. D., Saminathan, S. C., & Praveen Raj, P. (2019). Long-term outcomes of laparoscopic sleeve gastrectomy from the Indian subcontinent. Obesity Surgery, 29, 4043-4055.
10. Reorowicz, P., Tyfa, Z., Obidowski, D., Wiśniewski, K., Stefańczyk, L., Jóźwik, K., & Levy, M. L. (2022). Blood flow through the fusiform aneurysm treated with the Flow Diverter stent–Numerical investigations. Biocybernetics and Biomedical Engineering, 42(1), 375-390.
11. Rodríguez-Carrasco, M., Esposito, G., Libânio, D., Pimentel-Nunes, P., & Dinis-Ribeiro, M. (2020). Image-enhanced endoscopy for gastric preneoplastic conditions and neoplastic lesions: A systematic review and meta-analysis. Endoscopy, 52(12), 1048-1065.
12. Tanaka, Y., Takeuchi, H., Nakashima, Y., Nagano, H., Ueno, T., Tomizuka, K., Morita, S., Emi, Y., Hamai, Y., & Hihara, J. (2021). Effects of an elemental diet to reduce adverse events in patients with esophageal cancer receiving docetaxel/cisplatin/5-fluorouracil: a phase III randomized controlled trial—EPOC 2 (JFMC49-1601-C5). ESMO open, 6(5), 100277.
13. Tokairin, Y., Nagai, K., Kawada, K., & Kinugasa, Y. (2021). Mediastinoscopic esophagectomy for esophageal cancer: will this procedure achieve radical esophagectomy?—a narrative review. Digestive Medicine Research, 4.
14. Wong, D. T., & McGuire, G. P. (2000). Subcutaneous emphysema following trans-cricothyroid membrane injection of local anesthetic. Canadian journal of anaesthesia, 47, 165-168.
15. Yoshida, K., Tanaka, Y., Imai, T., Sato, Y., Hatanaka, Y., Suetsugu, T., Okumura, N., Matsuhashi, N., Takahashi, T., & Yamaguchi, K. (2020). Subtotal stomach in esophageal reconstruction surgery achieves an anastomotic leakage rate of less than 1%. Annals of Gastroenterological Surgery, 4(4), 422-432.
16. Zhong, L., Zhong, J., Tan, Z., Wei, Y., Su, X., Wen, Z., Rong, T., Hu, Y., & Luo, K. (2021). An approach to accelerate healing and shorten the hospital stay of patients with anastomotic leakage after esophagectomy: an explorative study of systematic endoscopic intervention. Frontiers in Oncology, 11, 657955.

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