Details

Autor(en) / Beteiligte

• Lehwald-Tywuschik, Nadja
• Steinfurth, Fabian
• Kröpil, Feride
• Krieg, Andreas
• Sarikaya, Hülya
• Knoefel, Wolfram Trudo
• Krüger, Martin
• Benhidjeb, Tahar
• Beshay, Morris
• Schulte Am Esch, Jan

Titel

Dorsal Track Control (DTC): A Modified Surgical Technique for Atraumatic Handling of the Distal Esophagus in Esophagojejunostomy

Ist Teil von

• Journal of Gastric Cancer, 2019, 19(4), , pp.473-483

Ort / Verlag

Korea (South): The Korean Gastric Cancer Association

Erscheinungsjahr

2019

Link zum Volltext

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Surgical therapy for adenocarcinoma of the esophagogastric junction II requires distal esophagectomy, in which a transhiatal management of the lower esophagus is critical. The 'dorsal track control' (DTC) maneuver presented here facilitates the atraumatic handling of the distal esophagus, in preparation for a circular-stapled esophagojejunostomy. It is based on a ventral semicircular incision in the distal esophagus, with an intact dorsal wall for traction control of the esophagus. The maneuver facilitates the proper placement of the purse-string suture, up to its tying (around the anvil), thus minimizing the manipulation of the remaining esophagus. Furthermore, the dorsally-exposed inner wall surface of the ventrally-opened esophagus serves as a guiding chute that eases anvil insertion into the esophageal lumen. We performed this novel technique in 21 cases, enabling a safe anastomosis up to 10 cm proximal to the Z-line. No anastomotic insufficiency was observed. The DTC technique improves high transhiatal esophagojejunostomy.