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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. und 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), S. 3869-3874.

Veröffentlichungsdatum dieses Volltextes: 17 Feb 2020 14:49
Artikel
DOI zum Zitieren dieses Dokuments: 10.5283/epub.41628


Zusammenfassung

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

DokumentenartArtikel
Titel eines Journals oder einer ZeitschriftWorld Journal of Gastroentereology
Verlag:BAISHIDENG PUBLISHING GROUP INC
Ort der Veröffentlichung:PLEASANTON
Band:22
Nummer des Zeitschriftenheftes oder des Kapitels:14
Seitenbereich:S. 3869-3874
Datum14 April 2016
Zusätzliche Informationen (Öffentlich)Open Access-Komponente aus einer Allianzlizenz
InstitutionenMedizin > Lehrstuhl für Chirurgie
Identifikationsnummer
WertTyp
10.3748/wjg.v22.i14.3869DOI
PMC4814751PubMedCentral-ID
27076773PubMed-ID
Stichwörter / 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-Dezimal-Klassifikation600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
StatusVeröffentlicht
BegutachtetJa, diese Version wurde begutachtet
An der Universität Regensburg entstandenJa
URN der UB Regensburgurn:nbn:de:bvb:355-epub-416285
Dokumenten-ID41628

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