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Erschienen in: Journal of Gastrointestinal Surgery 1/2022

10.09.2021 | Review Article

Outcomes of Gastric Conduit in Corrosive Esophageal Stricture: a Systematic Review and Meta-analysis

verfasst von: Raghav Nayar, Vaibhav Kumar Varshney, Akhil Dhanesh Goel

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 1/2022

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Abstract

Background

Gastric conduit has emerged as the preferred treatment option for both esophageal bypass and replacement for corrosive stricture of the esophagus. There is a lack of consensus and a dearth of published literature regarding the short- and long-term complications of using a gastric conduit. This meta-analysis aims to evaluate the outcomes, morbidity, and complications associated with it.

Methods

MEDLINE, Cochrane Library, and Google Scholar (January 1960 to May 2020) were systematically searched for all studies reporting short- and/or long-term outcomes and complications following the use of a gastric conduit for corrosive esophageal stricture.

Results

Seven observational studies involving 489 patients (53.2% males, mean age ranging from 22.1 to 41 years) who had ingested a corrosive substance (acid in 74.8%, alkali in 20.7%, and unknown in the rest) were analyzed. Gastric pull-up was performed in 56.03% (274/489) of patients. Median blood loss in the procedure was 187.5 ml with a mean operative duration of 298.75 ± 55.73 min. The overall pooled prevalence rate of anastomotic leak was 14.4% [95% CI (6.2–24.0); p < 0.05, I2 = 67.38], and anastomotic stricture was 27.2% [95% CI (13–42.8); p < 0.001, I2 = 80.11]. Recurrent dysphagia according to pooled prevalence estimates occurred in 14.4% patients [95% CI (5.4–25.1); p < 0.05, I2 = 69.1] and 90-day mortality in 4.8% patients [95% CI (1.5–9.1%); I2 = 31.1, p = 0.202]. The dreaded complication of conduit necrosis had a pooled prevalence of 1.3% [95% CI (0.1–3.4%); I2 = 0, p = 0.734].

Conclusion

The stomach can be safely used as the conduit of choice in corrosive strictures with an acceptable rate of complications, postoperative morbidity, and mortality.
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Literatur
1.
Zurück zum Zitat Mannell A. The Kirschner operation for cancer of the oesophagus. Annals of the Royal College of Surgeons of England. 1982;64(4):256. PubMedPubMedCentral Mannell A. The Kirschner operation for cancer of the oesophagus. Annals of the Royal College of Surgeons of England. 1982;64(4):256. PubMedPubMedCentral
2.
Zurück zum Zitat Hall AH, Jacquemin D, Henny D, Mathieu L, Josset P, Meyer B. Corrosive substances ingestion: a review. Critical reviews in toxicology. 2019;49(8):637-69. CrossRef Hall AH, Jacquemin D, Henny D, Mathieu L, Josset P, Meyer B. Corrosive substances ingestion: a review. Critical reviews in toxicology. 2019;49(8):637-69. CrossRef
3.
Zurück zum Zitat Varshney VK, Saluja SS, Mishra PK, Sisodia K, Sachan A, Sheetal P. Utilization of gastric conduit in the management of combined corrosive esophageal and stomach stricture. World journal of surgery. 2018;42(1):211-7. CrossRef Varshney VK, Saluja SS, Mishra PK, Sisodia K, Sachan A, Sheetal P. Utilization of gastric conduit in the management of combined corrosive esophageal and stomach stricture. World journal of surgery. 2018;42(1):211-7. CrossRef
4.
Zurück zum Zitat Gupta NM, Gupta R. Transhiatal esophageal resection for corrosive injury. Annals of surgery. 2004;239(3):359. CrossRef Gupta NM, Gupta R. Transhiatal esophageal resection for corrosive injury. Annals of surgery. 2004;239(3):359. CrossRef
5.
Zurück zum Zitat Javed A, Pal S, Dash NR, Sahni P, Chattopadhyay TK. Outcome following surgical management of corrosive strictures of the esophagus. Annals of surgery. 2011;254(1):62-6. CrossRef Javed A, Pal S, Dash NR, Sahni P, Chattopadhyay TK. Outcome following surgical management of corrosive strictures of the esophagus. Annals of surgery. 2011;254(1):62-6. CrossRef
6.
Zurück zum Zitat Harlak A, Yigit T, Coskun K, Ozer T, Mentes O, Gülec B, Kozak O. Surgical treatment of caustic esophageal strictures in adults. International Journal of Surgery. 2013;11(2):164-8. CrossRef Harlak A, Yigit T, Coskun K, Ozer T, Mentes O, Gülec B, Kozak O. Surgical treatment of caustic esophageal strictures in adults. International Journal of Surgery. 2013;11(2):164-8. CrossRef
7.
Zurück zum Zitat Włodarczyk J, Smęder T, Kużdżał J. Surgical Treatment Results of Burn-Related Oesophageal Strictures. World journal of surgery. 2017;41(3):790-5. CrossRef Włodarczyk J, Smęder T, Kużdżał J. Surgical Treatment Results of Burn-Related Oesophageal Strictures. World journal of surgery. 2017;41(3):790-5. CrossRef
8.
Zurück zum Zitat Saluja SS, Varshney VK, Mishra PK, Srivastava S, Meher R, Saxena P. Step-down approach for pharyngoesophageal corrosive stricture: outcome and analysis. World journal of surgery. 2017 ;41(8):2053-61. CrossRef Saluja SS, Varshney VK, Mishra PK, Srivastava S, Meher R, Saxena P. Step-down approach for pharyngoesophageal corrosive stricture: outcome and analysis. World journal of surgery. 2017 ;41(8):2053-61. CrossRef
9.
Zurück zum Zitat Varshney VK, Nag HH, Vageesh BG. Laparoscopic and open transhiatal oesophagectomy for corrosive stricture of the oesophagus: An experience. Journal of minimal access surgery. 2018;14(1):23. CrossRef Varshney VK, Nag HH, Vageesh BG. Laparoscopic and open transhiatal oesophagectomy for corrosive stricture of the oesophagus: An experience. Journal of minimal access surgery. 2018;14(1):23. CrossRef
10.
Zurück zum Zitat Barendregt JJ, Doi SA, Lee YY, Norman RE, Vos T. Meta-analysis of prevalence. J Epidemiol Community Health. 2013;67(11):974-8. CrossRef Barendregt JJ, Doi SA, Lee YY, Norman RE, Vos T. Meta-analysis of prevalence. J Epidemiol Community Health. 2013;67(11):974-8. CrossRef
11.
Zurück zum Zitat Furuya-Kanamori L, Barendregt JJ, Doi SA. A new improved graphical and quantitative method for detecting bias in meta-analysis. International journal of evidence-based healthcare. 2018;16(4):195-203. CrossRef Furuya-Kanamori L, Barendregt JJ, Doi SA. A new improved graphical and quantitative method for detecting bias in meta-analysis. International journal of evidence-based healthcare. 2018;16(4):195-203. CrossRef
12.
Zurück zum Zitat Liu J, Yang Y, Zheng C, Dong R, Zheng S. Surgical outcomes of different approaches to esophageal replacement in long-gap esophageal atresia: A systematic review. Medicine (Baltimore). 2017;96(21):e6942. CrossRef Liu J, Yang Y, Zheng C, Dong R, Zheng S. Surgical outcomes of different approaches to esophageal replacement in long-gap esophageal atresia: A systematic review. Medicine (Baltimore). 2017;96(21):e6942. CrossRef
13.
Zurück zum Zitat Urschel JD. Esophagogastrostomy anastomotic leaks complicating esophagectomy: a review. The American journal of surgery. 1995;169(6):634-40. CrossRef Urschel JD. Esophagogastrostomy anastomotic leaks complicating esophagectomy: a review. The American journal of surgery. 1995;169(6):634-40. CrossRef
14.
Zurück zum Zitat Gupta NM, Gupta R, Rao MS, Gupta V. Minimizing cervical esophageal anastomotic complications by a modified technique. The American journal of surgery. 2001;181(6):534-9. CrossRef Gupta NM, Gupta R, Rao MS, Gupta V. Minimizing cervical esophageal anastomotic complications by a modified technique. The American journal of surgery. 2001;181(6):534-9. CrossRef
15.
Zurück zum Zitat Brown J, Lewis WG, Foliaki A, Clark GW, Blackshaw GR, Chan DS. Colonic interposition after adult oesophagectomy: systematic review and meta-analysis of conduit choice and outcome. Journal of Gastrointestinal Surgery. 2018;22(6):1104-11. CrossRef Brown J, Lewis WG, Foliaki A, Clark GW, Blackshaw GR, Chan DS. Colonic interposition after adult oesophagectomy: systematic review and meta-analysis of conduit choice and outcome. Journal of Gastrointestinal Surgery. 2018;22(6):1104-11. CrossRef
16.
Zurück zum Zitat Motoyama S, Kitamura M, Saito R, Maruyama K, Sato Y, Hayashi K, et al. Surgical Outcome of Colon Interposition by the Posterior Mediastinal Route for Thoracic Esophageal Cancer. Ann Thorac Surg. 2007;83(4):1273–8. CrossRef Motoyama S, Kitamura M, Saito R, Maruyama K, Sato Y, Hayashi K, et al. Surgical Outcome of Colon Interposition by the Posterior Mediastinal Route for Thoracic Esophageal Cancer. Ann Thorac Surg. 2007;83(4):1273–8. CrossRef
17.
Zurück zum Zitat Raffensperger JG, Luck SR, Reynolds M, Schwartz D. Intestinal bypass of the esophagus. J Pediatr Surg. 1996;31(1):38-46; discussion 46-7. CrossRef Raffensperger JG, Luck SR, Reynolds M, Schwartz D. Intestinal bypass of the esophagus. J Pediatr Surg. 1996;31(1):38-46; discussion 46-7. CrossRef
18.
Zurück zum Zitat Cerfolio RJ, Allen MS, Deschamps C, Trastek VF, Pairolero PC. Esophageal replacement by colon interposition. Ann Thorac Surg. 1995;59(6):1382-4. CrossRef Cerfolio RJ, Allen MS, Deschamps C, Trastek VF, Pairolero PC. Esophageal replacement by colon interposition. Ann Thorac Surg. 1995;59(6):1382-4. CrossRef
19.
Zurück zum Zitat Famiglietti A, Lazar JF, Henderson H, Hamm M, Malouf S, Margolis M, Watson TJ, Khaitan PG. Management of anastomotic leaks after esophagectomy and gastric pull-up. Journal of thoracic disease. 2020;12(3):1022. CrossRef Famiglietti A, Lazar JF, Henderson H, Hamm M, Malouf S, Margolis M, Watson TJ, Khaitan PG. Management of anastomotic leaks after esophagectomy and gastric pull-up. Journal of thoracic disease. 2020;12(3):1022. CrossRef
20.
Zurück zum Zitat Javed A, Pal S, Krishnan EK, Sahni P, Chattopadhyay TK. Surgical management and outcomes of severe gastrointestinal injuries due to corrosive ingestion. World journal of gastrointestinal surgery. 2012;4(5):121. CrossRef Javed A, Pal S, Krishnan EK, Sahni P, Chattopadhyay TK. Surgical management and outcomes of severe gastrointestinal injuries due to corrosive ingestion. World journal of gastrointestinal surgery. 2012;4(5):121. CrossRef
21.
Zurück zum Zitat Spitz L, Kiely E, Pierro A. Gastric transposition in children—a 21-year experience. Journal of pediatric surgery. 2004;39(3):276-81. CrossRef Spitz L, Kiely E, Pierro A. Gastric transposition in children—a 21-year experience. Journal of pediatric surgery. 2004;39(3):276-81. CrossRef
22.
Zurück zum Zitat Wormuth JK, Heitmiller RF. Esophageal conduit necrosis. Thorac Surg Clin. 2006;16(1):11-22. CrossRef Wormuth JK, Heitmiller RF. Esophageal conduit necrosis. Thorac Surg Clin. 2006;16(1):11-22. CrossRef
23.
Zurück zum Zitat Han Y, Cheng QS, Li XF, Wang XP. Surgical management of esophageal strictures after caustic burns: a 30 years of experience. World J Gastroenterol. 2004;10(19):2846-9. CrossRef Han Y, Cheng QS, Li XF, Wang XP. Surgical management of esophageal strictures after caustic burns: a 30 years of experience. World J Gastroenterol. 2004;10(19):2846-9. CrossRef
24.
Zurück zum Zitat Awad K, Jaffray B. Oesophageal replacement with stomach: A personal series and review of published experience. J Paediatr Child Health. 2017;53(12):1159-1166. CrossRef Awad K, Jaffray B. Oesophageal replacement with stomach: A personal series and review of published experience. J Paediatr Child Health. 2017;53(12):1159-1166. CrossRef
25.
Zurück zum Zitat Chirica M, Resche-Rigon M, Bongrand NM, Zohar S, Halimi B, Gornet JM, Sarfati E, Cattan P. Surgery for caustic injuries of the upper gastrointestinal tract. Annals of surgery. 2012;256(6):994-1001. CrossRef Chirica M, Resche-Rigon M, Bongrand NM, Zohar S, Halimi B, Gornet JM, Sarfati E, Cattan P. Surgery for caustic injuries of the upper gastrointestinal tract. Annals of surgery. 2012;256(6):994-1001. CrossRef
26.
Zurück zum Zitat Gerzic ZB, Knezevic JB, Milicevic MN, Jovanovic BK. Esophagocoloplasty in the management of postcorrosive strictures of the esophagus. Annals of surgery. 1990;211(3):329. CrossRef Gerzic ZB, Knezevic JB, Milicevic MN, Jovanovic BK. Esophagocoloplasty in the management of postcorrosive strictures of the esophagus. Annals of surgery. 1990;211(3):329. CrossRef
27.
Zurück zum Zitat Kim YT, Sung SW, Kim JH. Is it necessary to resect the diseased esophagus in performing reconstruction for corrosive esophageal stricture? Eur J Cardiothorac Surg. 2001;20(1):1-6. CrossRef Kim YT, Sung SW, Kim JH. Is it necessary to resect the diseased esophagus in performing reconstruction for corrosive esophageal stricture? Eur J Cardiothorac Surg. 2001;20(1):1-6. CrossRef
28.
Zurück zum Zitat Nayar R, Varshney V, Suman S, Soni S, Kumar N. Thoracolaparoscopic-assisted esophagectomy for corrosive-induced esophageal stricture. Cureus. 2020;12(5):e7909. Nayar R, Varshney V, Suman S, Soni S, Kumar N. Thoracolaparoscopic-assisted esophagectomy for corrosive-induced esophageal stricture. Cureus. 2020;12(5):e7909.
29.
Zurück zum Zitat Davis PA, Law S, Wong J. Colonic interposition after esophagectomy for cancer. Arch Surg. 2003;138(3):303-8. CrossRef Davis PA, Law S, Wong J. Colonic interposition after esophagectomy for cancer. Arch Surg. 2003;138(3):303-8. CrossRef
Metadaten
Titel
Outcomes of Gastric Conduit in Corrosive Esophageal Stricture: a Systematic Review and Meta-analysis
verfasst von
Raghav Nayar
Vaibhav Kumar Varshney
Akhil Dhanesh Goel
Publikationsdatum
10.09.2021
Verlag
Springer US
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 1/2022
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-021-05124-9

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