Anastomotic leakage after esophagectomy possibly caused by compression of the gastric conduit behind the sternoclavicular joint: a report of three cases
Abstract Background The narrowness of the thoracic inlet is often a problem in retrosternal reconstruction after esophagectomy. We report here three cases in which compression of the gastric conduit behind the sternoclavicular joint possibly caused anastomotic leakage. Case presentations The first c...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2021-07-01
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| Series: | Surgical Case Reports |
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| Online Access: | https://doi.org/10.1186/s40792-021-01250-3 |
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| author | Yasunori Kurahashi Yudai Hojo Tatsuro Nakamura Tsutomu Kumamoto Yoshinori Ishida Hisashi Shinohara |
| author_facet | Yasunori Kurahashi Yudai Hojo Tatsuro Nakamura Tsutomu Kumamoto Yoshinori Ishida Hisashi Shinohara |
| author_sort | Yasunori Kurahashi |
| collection | DOAJ |
| description | Abstract Background The narrowness of the thoracic inlet is often a problem in retrosternal reconstruction after esophagectomy. We report here three cases in which compression of the gastric conduit behind the sternoclavicular joint possibly caused anastomotic leakage. Case presentations The first case was a 71-year-old man who underwent subtotal esophagectomy for upper esophageal cancer followed by retrosternal reconstruction. On postoperative day 2, he developed septic shock and underwent reoperation because of a necrotic gastric conduit. The tip of the conduit above the manubrium was necrotic due to strangulation as a result of compression by the sternoclavicular joint. The second and third cases were a 50-year-old woman and a 71-year-old man who underwent subtotal esophagectomy for middle and lower esophageal cancer, respectively, followed by retrosternal reconstruction. Despite indocyanine green fluorescence imaging indicating adequate blood flow in both cases, the tip of the conduit appeared pale and congested because of compression by the sternoclavicular joint after anastomosis. Postoperatively, these two patients developed anastomotic leakage that was confirmed endoscopically on the ventral side of the gastric wall that had been pale intraoperatively. Conclusions When performing reconstruction using the retrosternal route after esophagectomy, it is important to ensure that compression by the sternoclavicular joint does not have an adverse impact on blood flow at the tip of the gastric conduit. |
| first_indexed | 2024-12-20T01:51:15Z |
| format | Article |
| id | doaj.art-2b5544141e0b47aeb12a66613434786c |
| institution | Directory Open Access Journal |
| issn | 2198-7793 |
| language | English |
| last_indexed | 2024-12-20T01:51:15Z |
| publishDate | 2021-07-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj.art-2b5544141e0b47aeb12a66613434786c2022-12-21T19:57:38ZengSpringerOpenSurgical Case Reports2198-77932021-07-01711510.1186/s40792-021-01250-3Anastomotic leakage after esophagectomy possibly caused by compression of the gastric conduit behind the sternoclavicular joint: a report of three casesYasunori Kurahashi0Yudai Hojo1Tatsuro Nakamura2Tsutomu Kumamoto3Yoshinori Ishida4Hisashi Shinohara5Department of Gastroenterological Surgery, Hyogo College of MedicineDepartment of Gastroenterological Surgery, Hyogo College of MedicineDepartment of Gastroenterological Surgery, Hyogo College of MedicineDepartment of Gastroenterological Surgery, Hyogo College of MedicineDepartment of Gastroenterological Surgery, Hyogo College of MedicineDepartment of Gastroenterological Surgery, Hyogo College of MedicineAbstract Background The narrowness of the thoracic inlet is often a problem in retrosternal reconstruction after esophagectomy. We report here three cases in which compression of the gastric conduit behind the sternoclavicular joint possibly caused anastomotic leakage. Case presentations The first case was a 71-year-old man who underwent subtotal esophagectomy for upper esophageal cancer followed by retrosternal reconstruction. On postoperative day 2, he developed septic shock and underwent reoperation because of a necrotic gastric conduit. The tip of the conduit above the manubrium was necrotic due to strangulation as a result of compression by the sternoclavicular joint. The second and third cases were a 50-year-old woman and a 71-year-old man who underwent subtotal esophagectomy for middle and lower esophageal cancer, respectively, followed by retrosternal reconstruction. Despite indocyanine green fluorescence imaging indicating adequate blood flow in both cases, the tip of the conduit appeared pale and congested because of compression by the sternoclavicular joint after anastomosis. Postoperatively, these two patients developed anastomotic leakage that was confirmed endoscopically on the ventral side of the gastric wall that had been pale intraoperatively. Conclusions When performing reconstruction using the retrosternal route after esophagectomy, it is important to ensure that compression by the sternoclavicular joint does not have an adverse impact on blood flow at the tip of the gastric conduit.https://doi.org/10.1186/s40792-021-01250-3EsophagectomyAnastomotic leakageSternoclavicular jointCompressionIndocyanine green fluorescence imaging |
| spellingShingle | Yasunori Kurahashi Yudai Hojo Tatsuro Nakamura Tsutomu Kumamoto Yoshinori Ishida Hisashi Shinohara Anastomotic leakage after esophagectomy possibly caused by compression of the gastric conduit behind the sternoclavicular joint: a report of three cases Surgical Case Reports Esophagectomy Anastomotic leakage Sternoclavicular joint Compression Indocyanine green fluorescence imaging |
| title | Anastomotic leakage after esophagectomy possibly caused by compression of the gastric conduit behind the sternoclavicular joint: a report of three cases |
| title_full | Anastomotic leakage after esophagectomy possibly caused by compression of the gastric conduit behind the sternoclavicular joint: a report of three cases |
| title_fullStr | Anastomotic leakage after esophagectomy possibly caused by compression of the gastric conduit behind the sternoclavicular joint: a report of three cases |
| title_full_unstemmed | Anastomotic leakage after esophagectomy possibly caused by compression of the gastric conduit behind the sternoclavicular joint: a report of three cases |
| title_short | Anastomotic leakage after esophagectomy possibly caused by compression of the gastric conduit behind the sternoclavicular joint: a report of three cases |
| title_sort | anastomotic leakage after esophagectomy possibly caused by compression of the gastric conduit behind the sternoclavicular joint a report of three cases |
| topic | Esophagectomy Anastomotic leakage Sternoclavicular joint Compression Indocyanine green fluorescence imaging |
| url | https://doi.org/10.1186/s40792-021-01250-3 |
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