Preventing and localizing esophagogastric anastomosis leakage by sleeve-wrapping of the pedicled omentum

World J Gastroenterol. 2014 Nov 21;20(43):16282-6. doi: 10.3748/wjg.v20.i43.16282.

Abstract

Aim: To develop a technique of sleeve-wrapping the pedicled omentum around the esophagogastric anastomosis for preventing and localizing leakage.

Methods: This study includes data from 86 patients who were diagnosed with esophageal cancer and underwent the technique of sleeve-wrapping the pedicled omentum around esophagogastric anastomosis after esophagectomy between November 2011 and July 2013. The early complications that occurred during follow-up were analyzed.

Results: Postoperative complications included pulmonary complications (13/86; 15.1%) and abdominal or thoracic wound infection (3/86; 3.5%). Complications that occurred during follow-up included one case of anastomosis leakage (limited by omentum; 1.2%) and five case of anastomosis stricture (5.8%). No deaths occurred. All complications were resolved through traditional treatment. No additional surgery was needed.

Conclusion: Sleeve-wrapping of the pedicled omentum around esophagogastric anastomosis after esophagectomy is safe and effective for preventing and localizing anastomosis leakage without increasing anastomosis stricture.

Keywords: Anastomotic leakage; Esophageal cancer; Esophagectomy; Esophagogastrostomy; Pedicled omentum.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anastomotic Leak / diagnosis
  • Anastomotic Leak / etiology
  • Anastomotic Leak / prevention & control*
  • Endoscopy, Gastrointestinal
  • Esophageal Neoplasms / surgery*
  • Esophagectomy / methods*
  • Esophagostomy / adverse effects
  • Esophagostomy / methods*
  • Female
  • Gastrostomy / methods*
  • Humans
  • Male
  • Middle Aged
  • Omentum / surgery*
  • Surgical Flaps*
  • Time Factors
  • Treatment Outcome