Yellinedi Rajesh, Nuvvula Rambabu, Basude Madhunarayana, Kvvn Raju, Vashisht Yogesh, Nusrath Syed
Department of Plastic Surgery, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India.
Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, 500034 India.
Indian J Surg Oncol. 2024 Sep;15(3):536-540. doi: 10.1007/s13193-024-01946-6. Epub 2024 May 3.
The purpose of this study was to evaluate the effectiveness of incorporating additional venous anastomoses (venous super charging) in improving gastric conduit congestion and preventing complications such as conduit loss and anastomotic leakage following esophagectomy. We included two consecutive patients, one undergoing esophagectomy and the other undergoing laryngo-pharyngo-esophagectomy. Additional venous anastomoses were performed to alleviate venous congestion at the oral end of the gastric conduit. The perfusion assessment of the anastomosis was evaluated using indocyanine green fluorescence angiography (ICG FA) by Stryker's SPY PHI device. Both patients experienced anastomotic leakage, with one having a grade 2 leak and the other a grade 1 leak. Fortunately, conservative measures proved successful in managing these complications and there was no conduit loss. The incorporation of additional venous anastomoses effectively relieves venous congestion in the gastric conduit after esophagectomy and prevent conduit loss, indicating its potential in improving patient outcomes.
本研究的目的是评估增加静脉吻合术（静脉增压）在改善胃代食管通道充血以及预防食管切除术后诸如通道丢失和吻合口漏等并发症方面的有效性。我们纳入了两名连续的患者，一名接受食管切除术，另一名接受喉咽食管切除术。进行了额外的静脉吻合术以减轻胃代食管通道口端的静脉充血。使用史赛克的SPY PHI设备通过吲哚菁绿荧光血管造影（ICG FA）评估吻合口的灌注情况。两名患者均发生了吻合口漏，其中一名为2级漏，另一名为1级漏。幸运的是，保守措施成功处理了这些并发症，且未发生通道丢失。增加静脉吻合术可有效缓解食管切除术后胃代食管通道的静脉充血并预防通道丢失，表明其在改善患者预后方面的潜力。
