In:
Diseases of the Esophagus, Oxford University Press (OUP), Vol. 32, No. Supplement_2 ( 2019-11-23)
Abstract:
Acute gastric conduit necrosis (AGCN) is a serious early complication of esophagectomy that can result in loss of the gastric conduit. The reported incidence is relatively low: 0.5-3.2%. Literature is thus scarce. However, vascular comorbidity has been shown to be a risk factor. This study aimed to assess the arterial calcification scores, clinical presentation, management, and outcome of patients who suffered from AGCN following esophagectomy in a high volume centre for esophageal cancer surgery. Methods Patients who underwent esophagectomy for esophageal cancer were selected (Jan-2011 till Feb-2019) from a prospectively maintained single-centre database that contains the patient characteristics, treatment details, and postoperative outcomes of all patients undergoing esophagogastric surgery. For the AGCN cases, additional information regarding their clinical course was retrieved from the electronic patient files. Arterial calcification scores were established by measuring calcifications at 4 arterial locations on preoperative computed tomography (CT) scans. Results From a total of 466 esophagectomies performed in the inclusion period, AGCN occurred in 8 cases (1.7%). Resection of the gastric conduit was required in 5 of these patients, of whom 3 patients had a fatal outcome. The other patients were successfully treated by conservative treatment involving a nil by mouth regimen (n=2) or a self-expanding metal stent (n=1). There was a high prevalence of supra-aortic (75%) and thoracic (87.5%) calcifications in the patients suffering from AGCN. Conclusion AGCN is a rare but serious complication following esophagectomy, with a high mortality. Patients with generalized vascular disease may be at particular risk of developing this complication.
Type of Medium:
Online Resource
ISSN:
1442-2050
DOI:
10.1093/dote/doz092.94
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2019
detail.hit.zdb_id:
2004949-3
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