Delayed cervical esophagogastric anastomosis: a 5-year experience at the Hospital de Clínicas de Porto Alegre

• Autor(a) principal: T. Cavazzola, Leandro
• Data de Publicação: 2022
• Outros Autores: R. Gursk, Richard, C. Schirmer, Carlos, P. da Rosa, André Ricardo, Pesce, Guilherme, B. Telles, João Pedro, P. Kruel, Cleber Dario
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Clinical and Biomedical Research
• Texto Completo: https://seer.ufrgs.br/index.php/hcpa/article/view/125706
• topic: Carcinoma epidermóide de esôfago; cirurgia; anastomoses; fístulas; complicações pós-operatórias; óbito; Esophageal epidermoid carcinoma; surgery; postoperative complications; leakage; death

OBJECTIVE: Cervical esophagogastric anastomosis (CEA) is a common procedure used to restore the continuity of the digestive tract following curative or palliative surgery for esophageal cancer. At the HCPA, we carry out CEA procedures in two steps: first, we carry out a lateral cervical esophagostomy and position the esophageal substitute in the neck; second, after one week, the esophageal remnant is sutured to the esophageal substitute. The choice of esophageal substitute is made according to gastric pull-up (GP) or greater curvature gastric tube (GCGT), depending on the possibility of resection of the lesion. The objective of this paper is to describe the early results (up to 30 days) of delayed cervical esophagogastric anastomosis after resection or esophageal bypass procedures due to esophageal neoplasia. MATERIAL AND METHODS: Fifty-nine patients fulfilled the criteria for inclusion in our study, out of which there were 49 male and 55 white patients; the age average was of 51.5 years. Twenty-two patients were submitted to gastric pull-up. The risk factors for postoperative complications were similar for both groups. Tumor staging was the only difference between the two groups in preoperative examination; this difference was expected according to the criteria used for choosing the procedure. RESULTS: Seven patients (31.8%) of the GP group and in 9 patients (34.3%) from the GCGT group (RR 1.3; CI 95%: 0.5-3.0, P = 0.54) presented leakage. Two patients (9.1%) from the GP group and 1 (2.7%) from the GCGT group died (RR 3.4; CI 95%: 0.3-34.9, P = 0.54). One patient (4.5%) from the GP group and 7 (18.9%) patients from the GCGT group (RR 0.2; CI 95%: 0.1-1.8, P = 0.23) presented infections. There were no differences between the groups regarding occurrence of leakage, short-term postoperative death (until 30 days after surgery), and infections. CONCLUSIONS: Our results are similar to those of other services of reference for the treatment of esophageal cancer. In this study, we did not find any differences between the GP and GCGT groups regarding short-term postoperative complications.