80 cases without expanded pylorotomy during esophageal replacement by gastric tube

ABSTRACT

Aims: Esophageal replacement by gastric tube is present the procedure of choice in surgical treatment of carcinoma of esophagus. We would like to present our experiences in esophageal replacement by gastric tube without pyloroplasty in the Gastrointestinal Surgical Division at Binh Dan Hospital. Results: During 22 years (1979-2000), we performed 80 cases of esophagoplasty by gastric tube without pyloroplasty for 3 females and 77 males. The patient mean age was 61 years old. There were 51 cases of cancer of middle 1/3, 27 cases of cancer of the lower 1/3 and 2 cases of cancer of the cardio with esophageal extension. We had 24 cases of total esophagectomy, 29 cases of blunt esophagestomy and 27 cases of esophageal reconstruction by gastric tube. In 53 cases, gastric tube was in posterior mediastinum and 27 cases in substernal position. There were 15 patients presented postoperative pneumonia, 8 cases of anastomotic leakage in the neck, 4 cases of pneumothorax, 1 case with splenic rupture, 1 case of jejunal perforation, 2 cases of leakage of abdominal esophageal stump. The mean hospital stay was 20 days. No gastric emptying trouble was noted in this study. The functional results were good in patients survived this operation. Conclusion: The vascularization of the stomach was very good. In our experiences, esophageal reconstruction by gastric tube foiling Akiyama technique without pyloroplasty was suitable for all cases of esophageal cancer.