Transchiatal Esophagogasroplasty with Gastrostomia on the Neck

Abstract

Introduction: The formation of esophageal anastomosis with esophagogastroplasty is still associated with a high incidence of complications. The main cause of mortality after esophagogastroplasty is the failure of esophageal anastomosis. Aim: The aim of the research was to improve results of esophagogastroplasty by prevention of postoperative complications. Materials and methods: The research is based on the analysis of gastrostomy on the neck whith esophagogastroplasty in patients who were treated during 2010-2017 years. The method of surgery which includes the extirpation of the esophagus with transhiatal esophagogastroplasty simultaneously with the formation of a single esophagogastroanastomosis and contact gastrostomy on the the left side of the neck. Results: Intraoperatively nasogastral tube in patients who had got a partial failure of formed on the neck esophagogastroanastomosis as postoperative complications was not removed and it was used for enteral feeding and limited a zone of the anastomotic failure till its closure. Mortality rate is 5% (acute cardiovascular insufficiency caused the death of 1 patient). Conclusions: Developed and implemented in Clinic of the Institute method of a one-step transhiatal esophagogastroplasty with a single esophagogastroanastomosis and contact gastrostomy on the the left side of the neck in patients with extended postburn esophageal stricture in a condition of compensation and subcompensation can be considered as the treatment of choice.