Open Access Medical Books

Esophageal Reconstruction

Esophageal Reconstruction

Authored by Marta Strutyńska-Karpińska and Krzysztof Grabowski .

100 pages .
Open Access .
ISBN 978-953-51-0667-8 .


A significant development of esophageal reconstructive surgery can be observed over the years since 1907, when Cesar Roux first succeeded in performing the esophageal reconstruction  with a segment of the jejunum. Professional literature presents both, various modifications  of the surgical methods as well as original reconstructive procedures, which broaden significantly the range of surgical modalities and solutions in the surgical management of this condition.
However all the achievements have not led to the development of one, universal and generally accepted surgical method. The main reason of the situation lies in difficulty to standardize reconstructive surgeries. Progress in this respect achieved over time consists mainly in attempts to approximate optimally the function of the reconstructed esophagus to the function of a natural organ, and to minimize the number of both, early and late postsurgical complications.
Success of every reconstructive surgery with the use of pedicled intestinal segment is conditioned by efficient blood supply and adequate length of the pedicle that would enable free from tension anastomosis of the graft with cervical esophagus or the pharynx. Selection of an adequate segment of the intestine for esophageal grafting is in every case closely associated with the anatomical structure of the intestinal vasculature, what means that only the presence of well developed and efficient main blood vessels and their branching arcades may authorize the surgeon to start mobilizing this or another intestinal segment as an esophageal graft.
Abandonment of this basic principle leads to severe postsurgical complications.


Authors

-->

Contents :

  I Esophageal Reconstruction with Large Intestine .


1. Vascular anatomy of the colon ;
2. Esophageal reconstructions using the colon ;
3. Esophageal reconstructions using the right colon ;
    3.1. The technique of creation of an antiperistaltic graft from the right colon on ileocolic vascular pedicle ;
   3.2. The technique of construction of an isoperistaltic graft from the right colon on middle colic vascular pedicle ;
   3.3. The technique of construction of an isoperistaltic graft from the right colon on left colic vascular pedicle ;
4. Esophageal reconstructions using the left colon ;
    4.1. The technique of construction of an antiperistaltic graft from the left colon on middle colic vascular pedicle ;
    4.2. The technique of construction of an isoperistaltic graft from the left colon on left colic vascular pedicle ;
    4.3. The technique of construction of an antiperistaltic graft from the left colon on left colic vascular pedicle ;
5. References ;

 II Esophageal Reconstruction with Small Intestine .


1. Vascular anatomy of the small intestine ;
2. Esophageal reconstructions using the jejunum ;
3. Esophageal reconstructions using the ileum ;
3.1. Esophageal reconstruction with the use of the ileum alone ;
3.2. Esophageal reconstruction using the ileum and the caecum ;
3.3. Esophageal reconstruction using the ileum, the caecum and part of the ascending colon ;
4. References ;

 III Modifications and Complex Esophageal Reconstructions .


1. Modifications of esophageal reconstructions ;
    1.1. Resection of redundant intestine ;
2. Management of ischaemia in the cephalic portion of the jejunal graft ;
    2.1 Insertion from the ileum on middle colic vascular pedicle ;
    2.2. Insertion from the colon on ileocolic vascular pedicle ;
    2.3. Insertion from the colon on left colic vascular pedicle ;
    2.4. Secondary mobilization of the graft ;
3. References ;

 IV Diagnosis and Treatment of Postoperative Complications After Esophageal Reconstruction with Pedicled Intestinal Segments .


1. Early complications after esophageal reconstruction ;
    1.1. Necrosis of a part or a whole intestinal graft ;
    1.2. Pneumothorax ;
    1.3. Insufficiency of cervical anastomosis ;
    1.4. Salivary fistula in the region of cervical anastomosis ;
    1.5. Injury of the recurrent laryngeal nerve ;
2. Diagnosis and treatment of late complications after esophageal reconstructions ;
    2.1. Diagnosis of the esophageal substitute ;
    2.2. Late complications in the region of cervical anastomosis ;
    2.2.1 Cicatrical stenosis of the cervical anastomosis ;
    2.2.2. Diverticula in the region of cervical anastomosis ;
    2.2.3. Pleural hernia of the esophageal substitute ;
    2.2.4. Complications associated with reflux to the esophageal substitute ;
    2.2.5. Benign and malignant tumours of the esophageal substitute ;
3. References ;


 Download 

You've just read an article category Surgery by title Esophageal Reconstruction. You can bookmark this page URL http://www.openaccessbooks.com/2013/01/esophageal-reconstruction.html. Thank you!
Published by: younes younes - Wednesday, January 23, 2013

No comments yet "Esophageal Reconstruction"

Post a Comment