caa a22 4500 606204172 CHVBK 20210128101000.0 cr unu---uuuuu 210128e20150101xx s 000 0 eng 10.1007/s10388-014-0455-3 doi (NATIONALLICENCE)springer-10.1007/s10388-014-0455-3 Operative technique of antethoracic esophageal reconstruction with pedicled jejunal flap [Elektronische Daten] [Yasuhiro Shirakawa, Kazuhiro Noma, Takeshi Koujima, Naoaki Maeda, Shunsuke Tanabe, Toshiaki Ohara, Kazufumi Sakurama, Toshiyoshi Fujiwara] Background: Esophageal reconstruction using intestine is often performed for esophageal cancer patients in cases where the stomach cannot be used. We have previously performed reconstruction using ileocolon with supercharge and drainage as our first choice in those cases. However, a less invasive, simpler, and safer reconstructive technique using jejunum without vascular anastomosis has recently become popular at our facility. This study describes the technique of esophageal reconstruction with jejunum, compares the surgical outcomes to those of standard reconstruction using ileocolon, and discusses the clinical significance of this new concept. Patients and methods: Subjects comprised 53 patients (52 males, 1 female) who underwent esophageal reconstruction using jejunum between January 2008 and July 2013. Patient characteristics, technical details, and outcomes were compared with those of 51 subjects who had undergone esophageal reconstruction using ileocolon. When making the pedicled jejunal flap, the first jejunal vascular arcade was preserved, which in most cases allowed it to be pulled up to the cervical region by processing and transection up to the second jejunal vascular branch. Results: The vascular anastomosis techniques were used in 80.4% (41/51) of esophageal reconstructions using colon, compared with only 24.5% (13/53) of reconstructions using jejunum. No difference in the frequency of postoperative adverse effects was seen between groups, but the frequency of diarrhea was significantly lower with reconstruction using jejunum. Conclusion: Esophageal reconstruction using jejunum with the blood vessel processing technique results in both simpler and safer pulling up. Thus the need to perform supercharge and superdrainage is reduced. The Japan Esophageal Society and Springer Japan, 2014 Esophageal reconstruction nationallicence Pedicled jejunal flap nationallicence Supercharge nationallicence Superdrainage nationallicence Shirakawa Yasuhiro Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, 700-8558, Okayama, Japan aut Noma Kazuhiro Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, 700-8558, Okayama, Japan aut Koujima Takeshi Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, 700-8558, Okayama, Japan aut Maeda Naoaki Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, 700-8558, Okayama, Japan aut Tanabe Shunsuke Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, 700-8558, Okayama, Japan aut Ohara Toshiaki Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, 700-8558, Okayama, Japan aut Sakurama Kazufumi Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, 700-8558, Okayama, Japan aut Fujiwara Toshiyoshi Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, 700-8558, Okayama, Japan aut Esophagus Springer Japan 12/1(2015-01-01), 57-64 1612-9059 12:1<57 2015 12 10388 https://doi.org/10.1007/s10388-014-0455-3 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10388-014-0455-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shirakawa Yasuhiro Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, 700-8558, Okayama, Japan aut NATIONALLICENCE 700 1- Noma Kazuhiro Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, 700-8558, Okayama, Japan aut NATIONALLICENCE 700 1- Koujima Takeshi Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, 700-8558, Okayama, Japan aut NATIONALLICENCE 700 1- Maeda Naoaki Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, 700-8558, Okayama, Japan aut NATIONALLICENCE 700 1- Tanabe Shunsuke Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, 700-8558, Okayama, Japan aut NATIONALLICENCE 700 1- Ohara Toshiaki Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, 700-8558, Okayama, Japan aut NATIONALLICENCE 700 1- Sakurama Kazufumi Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, 700-8558, Okayama, Japan aut NATIONALLICENCE 700 1- Fujiwara Toshiyoshi Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, 700-8558, Okayama, Japan aut NATIONALLICENCE 773 0- Esophagus Springer Japan 12/1(2015-01-01), 57-64 1612-9059 12:1<57 2015 12 10388