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Weiss, Andreas ; Hackl, Christina ; Soeder, Yorick ; Schlitt, Hans J. ; Dahlke, Marc H.

Ileo-right hemi-colonic cervical pull-up on a non-supercharged ileocolic arterial pedicle: A technical and case report

Weiss, Andreas, Hackl, Christina, Soeder, Yorick, Schlitt, Hans J. and Dahlke, Marc H. (2016) Ileo-right hemi-colonic cervical pull-up on a non-supercharged ileocolic arterial pedicle: A technical and case report. World Journal of Gastroentereology 22 (14), pp. 3869-3874.

Date of publication of this fulltext: 17 Feb 2020 14:49
Article
DOI to cite this document: 10.5283/epub.41628


Abstract

Esophageal reconstruction can be challenging when stomach and colon are not anatomically intact and their use as esophageal substitutes is therefore limited. Innovative individual approaches are then necessary to restore the intestinal passage. We describe a technique in which a short stump of the right hemicolon and 25 cm of ileum on a long, non-supercharged, fully mobilized ileocolic arterial ...

Esophageal reconstruction can be challenging when stomach and colon are not anatomically intact and their use as esophageal substitutes is therefore limited. Innovative individual approaches are then necessary to restore the intestinal passage. We describe a technique in which a short stump of the right hemicolon and 25 cm of ileum on a long, non-supercharged, fully mobilized ileocolic arterial pedicle were used for esophageal reconstruction to the neck. In this case, a 65 year-old male patient had accidentally indigested hydrochloric acid which caused necrosis of his upper digestive tract. An emergency esophagectomy, gastrectomy, duodenectomy, pancreatectomy and splenectomy had been performed in an outside hospital. A cervical esophagostomy and a biliodigestive anastomosis had been created and a jejunal catheter for enteral feeding had been placed. After the patient had recovered, a reconstruction of his food passage via the left and transverse colon failed for technical reasons due to an intraoperative necrotic demarcation of the colon. Our team then faced the situation that only a short stump of the right hemi-colon was left in situ when the patient was referred to our center. After intensified nutritional therapy, we reconstructed this patient's food passage with the right hemicolon-approach described herein. After treatment of a postoperative pneumonia, the patient was discharged from hospital on the 26th postoperative day in a good clinical condition on an oral-only diet. In conclusion, individual approaches for long-segment reconstruction of the esophagus can be technically feasible in experienced hands. They do not always require arterial supercharging or free intestinal transplantation.



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Details

Item typeArticle
Journal or Publication TitleWorld Journal of Gastroentereology
Publisher:BAISHIDENG PUBLISHING GROUP INC
Place of Publication:PLEASANTON
Volume:22
Number of Issue or Book Chapter:14
Page Range:pp. 3869-3874
Date14 April 2016
Additional Information (public)Open Access-Komponente aus einer Allianzlizenz
InstitutionsMedicine > Lehrstuhl für Chirurgie
Identification Number
ValueType
10.3748/wjg.v22.i14.3869DOI
PMC4814751PubMedCentral-ID
27076773PubMed ID
KeywordsQUALITY-OF-LIFE; ESOPHAGEAL RECONSTRUCTION; LONG-TERM; ALIMENTARY SATISFACTION; JEJUNAL INTERPOSITION; GRAFT; REPLACEMENT; SURGERY; FLAP; Esophageal cancer; Esophageal trauma; Esophageal reconstruction; Gastric pull-up; Colonic interposition
Dewey Decimal Classification600 Technology > 610 Medical sciences Medicine
StatusPublished
RefereedYes, this version has been refereed
Created at the University of RegensburgYes
URN of the UB Regensburgurn:nbn:de:bvb:355-epub-416285
Item ID41628

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