Short-term outcomes of pedicled jejunum reconstruction after esophagectomy for esophageal cancer.

Authors

null

Mamoru Matano

Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

Mamoru Matano , Kengo Kanetaka , Shinichiro Kobayashi , Kazuma Kobayashi , Yusuke Inoue , Akihiko Soyama , Tomohiko Adachi , Susumu Eguchi

Organizations

Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan, Tissue Engineering and Regenerative therapeutics in Gastrointestinal Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

Research Funding

No funding sources reported

Background: The number of patients with esophageal cancer after gastrectomy and patients accompanied with simultaneous gastric cancer has gradually increased because of the prevalence of gastric in Japan. Pedicled jejunum is one of the choices for esophageal reconstruction when the stomach is not available. However, surgical outcomes of jejunal reconstruction and the effect of the timing of gastrectomy remain to be elucidated. Methods: This study was a retrospective, cohort study that included 24 patients who underwent supercharged pedicled jejunal conduit for esophageal reconstruction in our institution between May 2007 and July 2023. The patients were divided into two groups: gastrectomy was performed before esophagectomy (A group) and gastrectomy was performed simultaneously for accompanied gastric cancer (S group). Surgical outcomes and postoperative complications were compared between the two groups. As a nutritional assessment, perioperative change in body composition such as visceral fat area (VFA) with computed tomography was analyzed. Results: In 24 patients, the median operative time was 769 minutes and the median blood loss was 543 g. Severe postoperative complications developed in 6 cases (25%). The A group included 15 cases and the S group did 9 cases. There was no statistical difference in postoperative complication between the two groups, however, postoperative hospital stay was statistically longer in the S group than in that of the A group (37 days vs. 21 days, p=0.02). Although weight loss at 1 year after operation was almost identical in the two groups, the loss of VFA was more severe in the S group than in the A group (23 % of preoperative VFA vs. 77% of preoperative VFA, p=0.03). Conclusions: The use of a pedicled jejunal conduit after esophagectomy could be performed safely. Postoperative nutritional support is needed for patients especially those who underwent simultaneous gastrectomy.

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Abstract Details

Meeting

2024 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Cancers of the Esophagus and Stomach and Other Gastrointestinal Cancers

Track

Esophageal and Gastric Cancer,Other GI Cancer

Sub Track

Therapeutics

Citation

J Clin Oncol 42, 2024 (suppl 3; abstr 369)

DOI

10.1200/JCO.2024.42.3_suppl.369

Abstract #

369

Poster Bd #

H11

Abstract Disclosures