Oesophagogastric intramural implantation anastomosis after oesophagectomy

✍ Scribed by A. Archibong

• Book ID: 101749433
• Publisher: John Wiley and Sons
• Year: 1993
• Tongue: English
• Weight: 126 KB
• Volume: 80
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.1800801248

✦ Synopsis

Oesophagogastric intramural implantation anastomosis after oesophagectomy

Sir I found the Surgical Workshop by Dr Cheng and colleagues (Br J Surg 1992; 79: 1325-6) quite enlightening. The authors' ingenuity in creating the flap-valve effect prevents reflux and so ultimately oesophagitis. The risk of stricture as a complication is thus kept to a minimum.

The same principle of a flap-valve was reported by Stepanov' in children who had undergone resection of the ileocaecal junction for various lesions in this area, with subsequent ileocolic anastomosis. The method prevents reflux of colonic material into the ileum, forcing passage of intestinal contents in a unilateral direction. Our initial unpublished experimental studies on rats gave satisfactory results, and the method was subsequently introduced into paediatric clinical surgery. Complications are similar to those highlighted by Cheng and colleagues, namely stricture (stenosis), and are caused by oversewing, crushing by the clamp, poor apposition and local infection.

This method should find wide application when resecting lesions in the ileocaecal region.