Kim Hee Kyung, Jeon Hyun Woo
Department of Thoracic and Cardiovascular Surgery, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Thoracic and Cardiovascular Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.
J Chest Surg. 2023 Sep 5;56(5):362-366. doi: 10.5090/jcs.22.152. Epub 2023 Mar 15.
The stomach has become the most commonly used site for grafts to replace the esophagus in esophageal cancer surgery because of its good blood supply and ability to enable single-reconstruction anastomosis. However, anastomotic failure is a serious complication after esophageal cancer surgery. Unlike anastomotic leakage due to local ischemia, gastric tube necrosis is a life-threatening condition with a high mortality rate. Gastric tube necrosis involves extensive ischemia due to a decreased blood supply, and an urgent operation is mandatory in most cases. Endoscopic vacuum therapy (EVT) has been used for anastomotic leakage after esophageal surgery. In recent years, it has been successfully used for more extensive disease, including large esophageal perforation as an indication for reoperation. Hence, we report a case of extensive gastric tube necrosis treated by EVT after an Ivor Lewis operation.
由于胃具有良好的血供以及能够实现单重建吻合的能力，在食管癌手术中，胃已成为替代食管进行移植的最常用部位。然而，吻合口失败是食管癌手术后的一种严重并发症。与局部缺血导致的吻合口漏不同，胃管坏死是一种危及生命的情况，死亡率很高。胃管坏死是由于血供减少导致广泛缺血，在大多数情况下需要紧急手术。内镜下真空治疗（EVT）已用于食管手术后的吻合口漏。近年来，它已成功用于更广泛的疾病，包括作为再次手术指征的大的食管穿孔。因此，我们报告一例艾弗·刘易斯手术后经EVT治疗的广泛胃管坏死病例。
