Open AccessTechnique for Isoperistaltic Gastric Tube for Esophageal Bypass
Author(s) -
R. W. Postlethwait
Publication year - 1979
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 - 10.1097/00000658-197906000-00001
Subject(s) - medicine , curvatures of the stomach , esophagus , anastomosis , surgery , esophagectomy , swallowing , tube (container) , stomach , blood supply , right gastroepiploic artery , esophageal cancer , gastroenterology , cancer , artery , mechanical engineering , bypass grafting , engineering
There has not been described a uniformly successful method for palliation of inoperable carcinoma of the esophagus, especially malignant tracheoesophageal fistula. A gastric tube formed from the greater curvature of the stomach is being evaluated for these patients. The blood supply is based on the right gastroepiploic vessels. Using a stapler, one can form a gastric tube sufficiently long to reach the hypopharynx. Placed substernally, anastomosis to the cervical esophagus is performed. In 30 patients postoperative mortality has been 13%. No tube necrosis has occurred, but anastomotic leakage has been a problem. In those patients who had esophageal bypass for palliation and were discharged from the hospital, swallowing function has been satisfactory and the average survival has been 5.2 months.