Open AccessUnified Approach to Carcinoma of the Esophagus
Author(s) -
Ward O. Griffen,
Michael E. Daugherty,
Edgar M. McGee,
Joe R. Utley
Publication year - 1976
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-197605000-00008
Subject(s) - medicine , esophagus , curvatures of the stomach , anastomosis , surgery , right gastroepiploic artery , carcinoma , diaphragm (acoustics) , clavicle , stomach , esophagectomy , cancer , esophageal cancer , physics , artery , acoustics , bypass grafting , loudspeaker
The reversed gastric tube is advocated as a technique to be used in all patients who have carcinomas of the esophagus, whether the lesion is located in the upper, middle or lower esophagus. The tube, constructed out of the greater curvature of the stomach and supplied by the gastroepiploic vessels, invariably has adequate length and sufficient blood supply to heal per primum or to close anastomotic leaks spontaneously when they occur. Since the procedure requires a celiotomy and an incision in the neck, the presence and extent of metastatic disease below the diaphragm and above the clavicle can be evaluated. With prompt resumption of eating, the patients' nutritional status rapidly improves so that they can maintain weight during postoperative irradiation or further surgical procedures, e.g. esophagectomy. It is also effective as a palliative procedure since the patients handle their saliva and other secretions adequately after the procedure.