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Book Chapter: The Art and Science of Esophageal Anastomosis

TitleThe Art and Science of Esophageal Anastomosis
Authors
Issue Date2012
PublisherSpringer
Citation
The Art and Science of Esophageal Anastomosis. In Bonavina, L (Ed.), Innovation in Esophageal Surgery, p. 95-102. Milan; New York: Springer, 2012 How to Cite?
AbstractThe esophageal anastomosis is prone to leak and development of stricture. Tumor recurrence at the anastomosis is also a difficult problem to treat. Many aspects of the esophageal anastomosis are controversial. The choice of the site of the anastomosis is dependent on the location of the tumor and the method of esophagectomy. An adequate proximal resection margin ensures a low incidence of anastomotic recurrence. Leak from the esophageal anastomosis is largely technique-dependent. A hand-sewn or anastomosis with a circular stapler are equally safe though in some studies the later resulted in a higher stricture rate. This is avoided with the use of a semi-mechanical method with a linear stapler. Gastric conduit ischemia also predisposes to leaks; ischemic pre-conditioning of the gastric conduit though promising in the laboratory, has failed to result in better clinical outcome. Meticulous construction of the anastomosis and careful preparation of the gastric conduit with a tension free anastomosis are the keys to success. Death from anastomotic leak should be uncommon with modern peri-operative care.
Persistent Identifierhttp://hdl.handle.net/10722/181830
ISBN

 

DC FieldValueLanguage
dc.contributor.authorLaw, SYKen_US
dc.date.accessioned2013-03-19T04:01:24Z-
dc.date.available2013-03-19T04:01:24Z-
dc.date.issued2012en_US
dc.identifier.citationThe Art and Science of Esophageal Anastomosis. In Bonavina, L (Ed.), Innovation in Esophageal Surgery, p. 95-102. Milan; New York: Springer, 2012en_US
dc.identifier.isbn9788847024687en_US
dc.identifier.urihttp://hdl.handle.net/10722/181830-
dc.description.abstractThe esophageal anastomosis is prone to leak and development of stricture. Tumor recurrence at the anastomosis is also a difficult problem to treat. Many aspects of the esophageal anastomosis are controversial. The choice of the site of the anastomosis is dependent on the location of the tumor and the method of esophagectomy. An adequate proximal resection margin ensures a low incidence of anastomotic recurrence. Leak from the esophageal anastomosis is largely technique-dependent. A hand-sewn or anastomosis with a circular stapler are equally safe though in some studies the later resulted in a higher stricture rate. This is avoided with the use of a semi-mechanical method with a linear stapler. Gastric conduit ischemia also predisposes to leaks; ischemic pre-conditioning of the gastric conduit though promising in the laboratory, has failed to result in better clinical outcome. Meticulous construction of the anastomosis and careful preparation of the gastric conduit with a tension free anastomosis are the keys to success. Death from anastomotic leak should be uncommon with modern peri-operative care.-
dc.languageengen_US
dc.publisherSpringeren_US
dc.relation.ispartofInnovation in Esophageal Surgeryen_US
dc.titleThe Art and Science of Esophageal Anastomosisen_US
dc.typeBook_Chapteren_US
dc.identifier.emailLaw, SYK: slaw@hku.hken_US
dc.identifier.authorityLaw, SYK=rp00437en_US
dc.identifier.doi10.1007/978-88-470-2469-4_12-
dc.identifier.hkuros213486en_US
dc.identifier.spage95en_US
dc.identifier.epage102en_US
dc.publisher.placeMilan; New York-

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