title

بخیه آناستومیک عرضی در pull up معده ای: در یک مطالعه open-lable کنترل شده

فرانک, محمد رضا and اصغرپور, شهنام and پیوسته, مهران and سکوتی, محسن and فیضی, ایرج (1390) بخیه آناستومیک عرضی در pull up معده ای: در یک مطالعه open-lable کنترل شده. Kardiochirurgia i Torakochirurgia Polska ــ 8 (3). pp. 366-369. شاپا 1731-5530

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Title

Oblique versus transverse anastomotic stricture in gastric pull up: an open-label controlled trial

English Abstract

Background: Survival in esophageal cancer can be improved by surgery. In the palliative surgery for esophageal cancer, the fundus is anastomosed to the esophageal remnant, which is routinely transverse after esophagectomy. Developing stricture at the anastomosis precludes recovery from dysphagia. One study on esophageal cancer showed that the occurrenceof stricture formation in transverse esophagogastric anastomosis was 13.6%. Due to high prevalence of stricture formation in transverse anastomosis, we introduced a new technique (oblique anastomosis) and compared it with routine transverse anastomosis in a prospective randomized clinical trial. Materials and methods: This clinical trial was carried out in Imam Hospital (Tabriz, Iran) between 2003 and 2008. Two hundred subjects with biopsy-proven esophageal cancer entered the study in two groups of equal size. All patients underwent transhiatal esophagectomy (THE) and gastric pull-up. Cervical esophagogastric anastomosis randomly constructed in a transverse (T) and oblique (O) manner was completed in the two groups. In addition, two-layer hand-sewn anastomosis was done in both groups.Similar suture materials were used: non-absorbable for the posterior layer and absorbable for the inner layer. Results: There were 117 males (58.5%) and 83 females (41.5%) with a mean age of 60.47 years (range, 28–81 years). In the six-month follow-up period, 25 (12.5%) patients had dysphagia [20 (20%) cases in group T vs. 5 (5%) cases in group O (p = 0.001, 95% CI: 0.076–0.586, OR = 0.211]. Nineteen cases (9.5%) had structural anastomotic strictures 16 (16%) cases in group T vs. 3 (3%) cases in group O (p = 0.002, 95% CI: 0.046–0.577, OR = 0.162). Conclusion: This study showed that stricture formation was significantly lower in oblique esophagogastric anastomosis in THE than transverse anastomosis. Oblique technique is recommended for anastomosis.

Item Type:Article
زبان سند : انگلیسی
نویسنده اول :محمد رضا فرانک
نویسنده مسئول :شهنام اصغرپور
نویسنده :مهران پیوسته
نویسنده :محسن سکوتی
نویسنده :ایرج فیضی
Additional Information:Indexed in: Directory of Open Access Journals (DOAJ) International Committee of Medical Journal Editors (ICMJE) Index Copernicus , Polish Minsitry of Science and Higher Education (PMSHE) , Polish Medical Library (GBL) , SCIRUS , WorldCat
کلیدواژه ها (انگلیسی):esophageal cancer, esophageal stricture, dysphagia, oblique esophageal anastomosis, reflux, transverse esophageal anastomosis.
Subjects:WI Digestive System
WO Surgery
Divisions:Faculty of Medicine > Department of Surgery
ID Code:1587
Deposited By: Dr Ali Nemati
Deposited On:02 Feb 1393 11:18
Last Modified:02 Feb 1393 11:18

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