Anastomotic Leak, Constriction, Esophageal Neoplasms, Ischemia
Conditions
Brief summary
Gastric conduit ischemia or anastomotic breakdown after esophagectomy with cervical esophagogastrostomy often cause severe complications, such as leakage, necrotic organs, and strictures. Thus, the purpose of this study is the safety and efficacy of endoscopic evaluation about reconstructive organs after esophagectomy. The investigators evaluate endoscopic predictions using classifications in acute phase after esophagogastrostomy.
Detailed description
The development and improvement of thoracoscopic esophagectomy (TE) reduced the severe pulmonary complication after esophagectomy. However, the postoperative complications relative to gastric conduit reconstruction are still common issues after esophagectomy. The ischemia of the proximal portion of the graft predisposes these patients to a high incidence of anastomotic complications after esophagectomy. Less commonly, severe graft ischemia can lead to transmural necrosis. Thus, early diagnosis of ischemic reaction may provide the suitable postoperative management and therapeutic intervention to prevent leakage, strictures and necrosis. Thus, the purpose of this study is the safety and efficacy of endoscopic evaluation about reconstructive organs after esophagectomy. The investigators evaluate endoscopic predictions using classifications in acute phase after esophagogastrostomy.
Interventions
DIAGNOSTIC_TESTPatients after esophagectomy
Endoscopic examinations are performed at 1 and 8 postoperative days. Endoscopic examination is added when abnormal findings are demonstrated.
Sponsors
Nagasaki University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
20 Years to 84 Years
Healthy volunteers
No
Inclusion criteria
\- Malignant or end-stage benign esophageal disease. Esophagectomy with reconstruction by a gastric pull-up.
Exclusion criteria
\- Severe heart failure and pulmonary dysfunction Severe renal and liver dysfunction Allergenic history Pregnancy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The classification of gastric conduit ischemia by endoscopic findings predicts the major complications of gastric conduit (strictures, leakage, necrosis) | From 1 to 29 days after esophagectomy |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Biological examination of the mucosal biopsy of gastric conduit as assessed by the ischemia related RNA copy number | From 1 to 15 days after esophagectomy | — |
| Biological examination of the mucosal biopsy of gastric conduit as assessed by the scoring system for immunohistochemical staining | From 1 to 15 days after esophagectomy | The scoring system refer to the article entitled a scoring system for immunohistochemical staining: consensus report of the task force for basic research of the European Organization for Research and Treatment of Cancer-Gynaecological Cancer Cooperative Group |
| Biological examination of gastric conduit as assessed by the Mitochondrial DNA copy number | From 1 to 15 days after esophagectomy | — |
Countries
Japan
Outcome results
None listed