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Article: Colonic interposition after esophagectomy for cancer

TitleColonic interposition after esophagectomy for cancer
Authors
Issue Date2003
PublisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.com
Citation
Archives Of Surgery, 2003, v. 138 n. 3, p. 303-308 How to Cite?
AbstractHypothesis: The use of colonic interposition in esophageal replacement after esophagectomy for cancer results in similar morbidity, mortality, and long-term outcome compared with gastric transposition. Design: Prospectively collected database on patients with esophageal cancer from January 1, 1982, through December 31, 2000. Setting: Academic university hospital department of surgery. Patients: We compared 42 patients who underwent colonic interposition (colon group) with 959 patients who underwent gastric transposition (stomach group) after esophagectomy. Main Outcome Measures: Morbidity, mortality, and long-term survival. Results: Greater blood loss (median, 1000 vs 700 mL; P<.001) and longer operation duration (median, 270 vs 225 minutes; P<.001) were encountered in the colon group. We found no difference in cardiopulmonary complications, but we found significantly greater incidences of anastomotic leakage (14.3% vs 3.9%; P=.007) and intraabdominal septic complications (9.5% vs 0.2%; P<.001) in the colon group. Conduit ischemia developed in 5 patients (0.5%) in the stomach group, 3 of whom underwent successful staged reconstruction with colon. One patient (2.4%) in the colon group was found to have conduit ischemia and died. Hospital mortality rates included 7 patients (16.7%) from the colon group and 102 (10.6%) from the stomach group (P=.21). These figures improved to 0 and 27 (5.5%), respectively, in the second half of the study period (P>.99). Median survival was 12.8 and 10.4 months in the stomach and colon groups, respectively (P=.4). Conclusions: Colonic interposition is a more complex procedure with increased morbidity, compared with gastric transposition. Overall mortality and survival, however, were similar to those for gastric transposition.
Persistent Identifierhttp://hdl.handle.net/10722/83304
ISSN
2014 Impact Factor: 4.926
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorDavis, PAen_HK
dc.contributor.authorLaw, Sen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T08:39:26Z-
dc.date.available2010-09-06T08:39:26Z-
dc.date.issued2003en_HK
dc.identifier.citationArchives Of Surgery, 2003, v. 138 n. 3, p. 303-308en_HK
dc.identifier.issn0004-0010en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83304-
dc.description.abstractHypothesis: The use of colonic interposition in esophageal replacement after esophagectomy for cancer results in similar morbidity, mortality, and long-term outcome compared with gastric transposition. Design: Prospectively collected database on patients with esophageal cancer from January 1, 1982, through December 31, 2000. Setting: Academic university hospital department of surgery. Patients: We compared 42 patients who underwent colonic interposition (colon group) with 959 patients who underwent gastric transposition (stomach group) after esophagectomy. Main Outcome Measures: Morbidity, mortality, and long-term survival. Results: Greater blood loss (median, 1000 vs 700 mL; P<.001) and longer operation duration (median, 270 vs 225 minutes; P<.001) were encountered in the colon group. We found no difference in cardiopulmonary complications, but we found significantly greater incidences of anastomotic leakage (14.3% vs 3.9%; P=.007) and intraabdominal septic complications (9.5% vs 0.2%; P<.001) in the colon group. Conduit ischemia developed in 5 patients (0.5%) in the stomach group, 3 of whom underwent successful staged reconstruction with colon. One patient (2.4%) in the colon group was found to have conduit ischemia and died. Hospital mortality rates included 7 patients (16.7%) from the colon group and 102 (10.6%) from the stomach group (P=.21). These figures improved to 0 and 27 (5.5%), respectively, in the second half of the study period (P>.99). Median survival was 12.8 and 10.4 months in the stomach and colon groups, respectively (P=.4). Conclusions: Colonic interposition is a more complex procedure with increased morbidity, compared with gastric transposition. Overall mortality and survival, however, were similar to those for gastric transposition.en_HK
dc.languageengen_HK
dc.publisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.comen_HK
dc.relation.ispartofArchives of Surgeryen_HK
dc.titleColonic interposition after esophagectomy for canceren_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0004-0010&volume=138&issue=3&spage=303&epage=308&date=2003&atitle=Colonic+interposition+after+esophagectomy+for+canceren_HK
dc.identifier.emailLaw, S: slaw@hku.hken_HK
dc.identifier.authorityLaw, S=rp00437en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1001/archsurg.138.3.303en_HK
dc.identifier.pmid12611579-
dc.identifier.scopuseid_2-s2.0-0037337363en_HK
dc.identifier.hkuros78571en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0037337363&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume138en_HK
dc.identifier.issue3en_HK
dc.identifier.spage303en_HK
dc.identifier.epage308en_HK
dc.identifier.isiWOS:000181435200015-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridDavis, PA=7403509648en_HK
dc.identifier.scopusauthoridLaw, S=7202241293en_HK
dc.identifier.scopusauthoridWong, J=7404435808en_HK

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