COMPARATIVE ANALYSIS OF LATE RESULTS OF CERVICAL ESOPHAGOGASTRIC ANASTOMOSIS BY MANUAL AND MECHANICAL SUTURE IN PATIENTS SUBMITTED TO ESOPHAGEAL MUCOSECTOMY THROUGH ADVANCED MEGAESOPHAGUS
ABSTRACT Background: Among the anastomoses of the gastrointestinal tract, those of the esophagus are of special interest due to several anatomical or even general peculiarities. Aim: Evaluate retrospectively the results comparing mechanical vs. manual suture at cervical esophagogastric anastomosis...
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| Format: | Article |
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Colégio Brasileiro de Cirurgia Digestiva
2019-12-01
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| Series: | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202019000400301&tlng=en |
| _version_ | 1798019632923148288 |
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| author | José Luis Braga de AQUINO Vania Aparecida LEANDRO-MERHI José Alexandre MENDONÇA Elisa Donalisio Teixeira MENDES Conceição de Maria Aquino Vieira CLAIRET Leonardo Oliveira REIS |
| author_facet | José Luis Braga de AQUINO Vania Aparecida LEANDRO-MERHI José Alexandre MENDONÇA Elisa Donalisio Teixeira MENDES Conceição de Maria Aquino Vieira CLAIRET Leonardo Oliveira REIS |
| author_sort | José Luis Braga de AQUINO |
| collection | DOAJ |
| description | ABSTRACT Background: Among the anastomoses of the gastrointestinal tract, those of the esophagus are of special interest due to several anatomical or even general peculiarities. Aim: Evaluate retrospectively the results comparing mechanical vs. manual suture at cervical esophagogastric anastomosis in megaesophagus treatment. Methods: Were included 92 patients diagnosed with advanced megaesophagus with clinical conditions to undergo the surgery. All underwent esophageal mucosectomy, performing anastomosis of the esophagus stump with the gastric tube at the cervical level. In order to make this anastomosis, the patients were divided into two groups: group A (n=53) with circular mechanical suture, lateral end; group B (n=39) with manual suture in two sides, lateral end. In the postoperative period, an early evaluation was performed, analyzing local and systemic complications and late (average 5.6 y) analyzing deglutition. Results: Early evaluation: a) dehiscence of esophagogastric anastomosis n=5 (9.4%) in group A vs. n=9 (23.0%) in group B (p=0.0418); b) stenosis of esophagogastric anastomosis n=8 (15.1%) in group A vs. n=15 (38.4%) in group B (p=0.0105.); c) pulmonary infection n=5 (9.4%) in group A vs. n=3 (7.6%) in group B (p=1.0000.); d) pleural effusion n=5 (9.4%) in group A vs. n=6 (15.4%) in group B (p<0.518). Late evaluation showed that 86.4-96% of the patients presented the criteria 4 and 5 from SAEED, expressing effective swallowing mechanisms without showing significant differences among the groups. Conclusion: Cervical esophagogastric anastomosis by means of mechanical suture is more proper than the manual with lower incidence of local complications and, in the long-term evaluation, regular deglutition was acquired in both suture techniques in equal quality. |
| first_indexed | 2024-04-11T16:43:57Z |
| format | Article |
| id | doaj.art-8a947e0302db4ad8a60fb9d5a1a75e0c |
| institution | Directory Open Access Journal |
| issn | 0102-6720 |
| language | English |
| last_indexed | 2024-04-11T16:43:57Z |
| publishDate | 2019-12-01 |
| publisher | Colégio Brasileiro de Cirurgia Digestiva |
| record_format | Article |
| series | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| spelling | doaj.art-8a947e0302db4ad8a60fb9d5a1a75e0c2022-12-22T04:13:37ZengColégio Brasileiro de Cirurgia DigestivaABCD: Arquivos Brasileiros de Cirurgia Digestiva0102-67202019-12-0132410.1590/0102-672020190001e1462COMPARATIVE ANALYSIS OF LATE RESULTS OF CERVICAL ESOPHAGOGASTRIC ANASTOMOSIS BY MANUAL AND MECHANICAL SUTURE IN PATIENTS SUBMITTED TO ESOPHAGEAL MUCOSECTOMY THROUGH ADVANCED MEGAESOPHAGUSJosé Luis Braga de AQUINOhttps://orcid.org/0000-0002-0604-9054Vania Aparecida LEANDRO-MERHIhttps://orcid.org/0000-0003-2859-0228José Alexandre MENDONÇAhttps://orcid.org/0000-0003-1689-6705Elisa Donalisio Teixeira MENDEShttps://orcid.org/0000-0003-4251-8185Conceição de Maria Aquino Vieira CLAIREThttps://orcid.org/0000-0001-5889-8149Leonardo Oliveira REIShttps://orcid.org/0000-0003-2092-414XABSTRACT Background: Among the anastomoses of the gastrointestinal tract, those of the esophagus are of special interest due to several anatomical or even general peculiarities. Aim: Evaluate retrospectively the results comparing mechanical vs. manual suture at cervical esophagogastric anastomosis in megaesophagus treatment. Methods: Were included 92 patients diagnosed with advanced megaesophagus with clinical conditions to undergo the surgery. All underwent esophageal mucosectomy, performing anastomosis of the esophagus stump with the gastric tube at the cervical level. In order to make this anastomosis, the patients were divided into two groups: group A (n=53) with circular mechanical suture, lateral end; group B (n=39) with manual suture in two sides, lateral end. In the postoperative period, an early evaluation was performed, analyzing local and systemic complications and late (average 5.6 y) analyzing deglutition. Results: Early evaluation: a) dehiscence of esophagogastric anastomosis n=5 (9.4%) in group A vs. n=9 (23.0%) in group B (p=0.0418); b) stenosis of esophagogastric anastomosis n=8 (15.1%) in group A vs. n=15 (38.4%) in group B (p=0.0105.); c) pulmonary infection n=5 (9.4%) in group A vs. n=3 (7.6%) in group B (p=1.0000.); d) pleural effusion n=5 (9.4%) in group A vs. n=6 (15.4%) in group B (p<0.518). Late evaluation showed that 86.4-96% of the patients presented the criteria 4 and 5 from SAEED, expressing effective swallowing mechanisms without showing significant differences among the groups. Conclusion: Cervical esophagogastric anastomosis by means of mechanical suture is more proper than the manual with lower incidence of local complications and, in the long-term evaluation, regular deglutition was acquired in both suture techniques in equal quality.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202019000400301&tlng=enEsophageal achalasiaAnastomosis, surgicalSuture techniques |
| spellingShingle | José Luis Braga de AQUINO Vania Aparecida LEANDRO-MERHI José Alexandre MENDONÇA Elisa Donalisio Teixeira MENDES Conceição de Maria Aquino Vieira CLAIRET Leonardo Oliveira REIS COMPARATIVE ANALYSIS OF LATE RESULTS OF CERVICAL ESOPHAGOGASTRIC ANASTOMOSIS BY MANUAL AND MECHANICAL SUTURE IN PATIENTS SUBMITTED TO ESOPHAGEAL MUCOSECTOMY THROUGH ADVANCED MEGAESOPHAGUS ABCD: Arquivos Brasileiros de Cirurgia Digestiva Esophageal achalasia Anastomosis, surgical Suture techniques |
| title | COMPARATIVE ANALYSIS OF LATE RESULTS OF CERVICAL ESOPHAGOGASTRIC ANASTOMOSIS BY MANUAL AND MECHANICAL SUTURE IN PATIENTS SUBMITTED TO ESOPHAGEAL MUCOSECTOMY THROUGH ADVANCED MEGAESOPHAGUS |
| title_full | COMPARATIVE ANALYSIS OF LATE RESULTS OF CERVICAL ESOPHAGOGASTRIC ANASTOMOSIS BY MANUAL AND MECHANICAL SUTURE IN PATIENTS SUBMITTED TO ESOPHAGEAL MUCOSECTOMY THROUGH ADVANCED MEGAESOPHAGUS |
| title_fullStr | COMPARATIVE ANALYSIS OF LATE RESULTS OF CERVICAL ESOPHAGOGASTRIC ANASTOMOSIS BY MANUAL AND MECHANICAL SUTURE IN PATIENTS SUBMITTED TO ESOPHAGEAL MUCOSECTOMY THROUGH ADVANCED MEGAESOPHAGUS |
| title_full_unstemmed | COMPARATIVE ANALYSIS OF LATE RESULTS OF CERVICAL ESOPHAGOGASTRIC ANASTOMOSIS BY MANUAL AND MECHANICAL SUTURE IN PATIENTS SUBMITTED TO ESOPHAGEAL MUCOSECTOMY THROUGH ADVANCED MEGAESOPHAGUS |
| title_short | COMPARATIVE ANALYSIS OF LATE RESULTS OF CERVICAL ESOPHAGOGASTRIC ANASTOMOSIS BY MANUAL AND MECHANICAL SUTURE IN PATIENTS SUBMITTED TO ESOPHAGEAL MUCOSECTOMY THROUGH ADVANCED MEGAESOPHAGUS |
| title_sort | comparative analysis of late results of cervical esophagogastric anastomosis by manual and mechanical suture in patients submitted to esophageal mucosectomy through advanced megaesophagus |
| topic | Esophageal achalasia Anastomosis, surgical Suture techniques |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202019000400301&tlng=en |
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