naa a22 4500 510740774 CHVBK 20180411083027.0 cr unu---uuuuu 180411e20130901xx s 000 0 eng 10.1007/s11845-013-0917-y doi (NATIONALLICENCE)springer-10.1007/s11845-013-0917-y Tubular stomach or whole stomach for esophagectomy through cervico-thoraco-abdominal approach: a comparative clinical study on anastomotic leakage [Elektronische Daten] [Y.-S. Shu, C. Sun, W.-P. Shi, H.-C. Shi, S.-C. Lu, K. Wang] Background: Esophagectomy through cervico-thoraco-abdominal approach is a useful surgical technique in treating patients with esophageal cancer. However, the cervical reconstruction is also known to have a high rate of anastomotic leakage, as well as anastomotic stricture, intrathoracic stomach syndrome, reflux esophagitis and other complications, thereby influencing postoperative recovery and quality of life. Aims: The objective of this study was to investigate whether tubular stomach is superior to whole stomach in reducing anastomotic leakage for esophageal reconstruction through the cervico-thoraco-abdominal (3-field) approach. Methods: A total of 850 patients undergoing the 3-field esophagectomy were retrospectively included in this study and divided into a tubular stomach reconstruction group (Group A, n=453) and a whole stomach reconstruction group (Group B, n=397). All patients underwent esophagectomy through right thorax, left cervical part, abdominal triple incisions and done in esophageal reconstruction by hand-sewn two-layer anastomosis. Results: Results revealed that in comparison with whole stomach, esophageal reconstruction with tubular stomach had a lower incidence of anastomotic leakage (5.5 vs. 9.3%, P<0.05), less manifestation of intrathoracic syndrome (3.3 vs. 9.8%, P<0.001) and less occurence of reflux esophagitis (5.1 vs. 11.1%, P<0.01). However, for the incidence of anastomotic stricture, there was no significant difference between the two groups (9.3 vs. 9.8%). Conclusions: This observation study suggests that for esophageal cancer patients undergoing the 3-field esophagectomy tubular stomach is better than whole stomach for esophageal reconstruction as reflected by a reduced postoperative anastomotic leakage, intrathoracic syndrome and reflux esophagitis. Royal Academy of Medicine in Ireland, 2013 Tubular stomach nationallicence 3-field esophagectomy nationallicence Esophageal cancer nationallicence Anastomotic leakage nationallicence Whole stomach nationallicence Complications nationallicence Shu Y.-S Department of Cardiothoracic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 98 West Nantong Road, 225001, Yangzhou, Jiangsu Province, China aut Sun C. Department of Cardiothoracic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 98 West Nantong Road, 225001, Yangzhou, Jiangsu Province, China aut Shi W.-P Department of Cardiothoracic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 98 West Nantong Road, 225001, Yangzhou, Jiangsu Province, China aut Shi H.-C Department of Cardiothoracic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 98 West Nantong Road, 225001, Yangzhou, Jiangsu Province, China aut Lu S.-C Department of Cardiothoracic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 98 West Nantong Road, 225001, Yangzhou, Jiangsu Province, China aut Wang K. Department of Cardiothoracic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 98 West Nantong Road, 225001, Yangzhou, Jiangsu Province, China aut Irish Journal of Medical Science Springer-Verlag 182/3(2013-09-01), 477-480 0021-1265 182:3<477 2013 182 11845 https://doi.org/10.1007/s11845-013-0917-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11845-013-0917-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shu Y.-S Department of Cardiothoracic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 98 West Nantong Road, 225001, Yangzhou, Jiangsu Province, China aut NATIONALLICENCE 700 1- Sun C. Department of Cardiothoracic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 98 West Nantong Road, 225001, Yangzhou, Jiangsu Province, China aut NATIONALLICENCE 700 1- Shi W.-P Department of Cardiothoracic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 98 West Nantong Road, 225001, Yangzhou, Jiangsu Province, China aut NATIONALLICENCE 700 1- Shi H.-C Department of Cardiothoracic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 98 West Nantong Road, 225001, Yangzhou, Jiangsu Province, China aut NATIONALLICENCE 700 1- Lu S.-C Department of Cardiothoracic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 98 West Nantong Road, 225001, Yangzhou, Jiangsu Province, China aut NATIONALLICENCE 700 1- Wang K. Department of Cardiothoracic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 98 West Nantong Road, 225001, Yangzhou, Jiangsu Province, China aut NATIONALLICENCE 773 0- Irish Journal of Medical Science Springer-Verlag 182/3(2013-09-01), 477-480 0021-1265 182:3<477 2013 182 11845 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer