Roux-en-Y Diversion for Intractable Reflux After Esophagectomy

Slides:

Advertisements

Similar presentations

Ninh T. Nguyen, MD, Cam-Ly Tran, MD, Dmitri V

Advertisements

Prevention of Delayed Gastric Emptying After Esophagectomy: A Single Center's Experience With Botulinum Toxin Jeremiah T. Martin, MD, John A. Federico,

Afif N. Kulaylat, MD, Sunny Sahajwani, MD, MHS, Kevin F

Sternal Dehiscence After Clamshell Incision in Lung Transplantation Treated With the STRAsbourg Thoracic Osteosyntheses System (STRATOS) Bastien Orsini,

Preoperative Laparoscopic Ligation of the Left Gastric Vessels in Preparation for Esophagectomy Ninh T. Nguyen, MD, Mario Longoria, MD, Allen Sabio,

Adenocarcinoma in a 40-Year-Old Colonic Interposition Treated With Ivor Lewis Esophagectomy and Esophagogastric Anastomosis David D. Shersher, MD, Edward.

Kyla D. Joubert, MD, Richard D. Betzold, MD, Matthew A. Steliga, MD

Surgical Management of Medically Refractory Tietze Syndrome

Reverse-Puncture Anastomotic Technique for Minimally Invasive Ivor-Lewis Esophagectomy Ping Xiao, MD, Xiang Zhuang, MD, Yi Shen, MD, Qiang Li, MD, Wei.

Lisa M. Brown, MD, MAS, David T. Cooke, MD, Elizabeth A. David, MD

Ivor Lewis Esophagectomy in a Patient With Enlarged Azygos Vein: A Lesson to Learn Antonio Martín-Malagón, MD, Alberto Bravo, PhD, Iván Arteaga, PhD,

Impact of Gastropyloric Motor Activity on the Genesis of Reflux Esophagitis After an Esophagectomy With Gastric Tube Reconstruction Toshihiro Nakabayashi,

Lindsay C.H. John, MD, FRCS The Annals of Thoracic Surgery

Right Gastroepiploic Artery Graft for Myocardial Revascularization: Prevalence of Atherosclerosis and Availability as a Conduit Kwang Ree Cho, MD, PhD,

Pieter C. van der Sluis, MD, Roy J. J

Jae-Ik Lee, MD, PhD, Sunghoon Choi, MS, Jaeyong Sung, PhD

Mark D. Iannettoni, MD, William R. Lynch, MD, Kalpaj R

Jejunal Interposition for Esophageal Replacement

Chest wall and liver resection for chondrosarcoma

Eduardo Crema, PhD, MD, Lara B. P. Ribeiro, Juverson A. Terra, Alex A

Rapid progression of Barrett's esophagus into adenocarcinoma in a combined lung and kidney transplant recipient Waleed Saleh, MD, Andre Duranceau, MD,

Christopher W. Seder, MD, Bassem T. Elhassan, MD, Dennis A

Theolyn N. Price, MD, Mark S. Allen, MD, Francis C

Cullen D. Morris, MD, Francis Owings, MD, Joseph I. Miller, MD

Esophagectomy and Gastric Pull-Up in Patients With Previous Free Jejunal Transfer Yoshinori Hosoya, MD, PhD, Shunji Sarukawa, MD, PhD, Shiro Matsumoto,

Laparoscopic and Thoracoscopic Ivor Lewis Esophagectomy With Colonic Interposition Ninh T. Nguyen, MD, FACS, Marcelo Hinojosa, MD, Christine Fayad, BS,

Roux-en-Y Near Esophagojejunostomy for Intractable Gastroesophageal Reflux After Antireflux Surgery Omar Awais, DO, James D. Luketich, MD, John Tam,

Ichiro Kashima, MD, Yoshihiko Mochizuki, MD, Masahiko Okamoto, MD

A New Option for Autologous Anterior Chest Wall Reconstruction: The Composite Thoracodorsal Artery Perforator Flap Sandy Dast, MD, Pascal Berna, MD,

James D. St. Louis, MD The Annals of Thoracic Surgery

Who Do You Say You Are? The Annals of Thoracic Surgery

The “Double-Valve” Sign in Acute Type A Aortic Dissection

Use of Amiodarone After Major Lung Resection

Stapler-Based Thoracoscopic Basilar Segmentectomy

Treatment of Sternal Wound Infection Using a Free Myocutaneous Flap

Robert J. Cerfolio, MD, Thomas C. Matthews, BS

Anomalous Origin of Left Pulmonary Artery From Left Subclavian Artery

Sternal Closure With Tie Bands: A Word of Caution

Pulmonary Artery Reconstruction With Pulmonary Vein Conduit for Lung Cancer: Medium-Term Results Antonio D'Andrilli, MD, Giulio Maurizi, MD, Claudio.

Juan A. Cordero, MD, Darroch W.O. Moores, MD

Pursestring Stapled Anastomotic Technique for Minimally Invasive Ivor Lewis Esophagectomy Ren-Quan Zhang, MD, Wan-Li Xia, MD, Ning-Ning Kang, MD, Wei.

Redo Aortic Valve Replacement in Children

Foreign Bodies in Pleura and Chest Wall

Pectoral Muscle Flap With V-Y Skin Paddle for Covering Sternal Defects

Editorial Board, January 2010

Minimally Invasive Esophagogastrectomy for Esophagogastric Junctional Cancer Hirokazu Noshiro, MD, Yoshihiro Miyasaka, MD, Michiaki Akashi, MD, Hironori.

Severe Two-Vessel Ostial Stenosis of the Main Coronary Arteries in a Patient With Transposition of the Great Arteries After an Arterial Switch Operation

Arch Aneurysm Repair With Long Elephant Trunk: A 10-Year Experience in 111 Patients Koichi Toda, MD, Kazuhiro Taniguchi, MD, Takafumi Masai, MD, Toshiki.

Completely Thrombosed Tricuspid Pouch Mimicking a Cardiac Tumor

Daniel Pop, MD, Nicolas Venissac, MD, Ahmad S

PillCam in Gastric Conduit After Ivor Lewis Esophagectomy

The Unifocal Bilateral Bidirectional Cavopulmonary Anastomosis

Tom Treasure, MD The Annals of Thoracic Surgery

Patrick O. Myers, MD The Annals of Thoracic Surgery

Contraceptive Implant Embolism Into the Pulmonary Artery: Thoracoscopic Retrieval Pascal A. Thomas, MD, PhD, Donatella Di Stefano, MD, Cécile Couteau,

Kristin B. Miller, MD, Brian Kaplan, MD, Ray W. Shepherd, MD

The Annals of Thoracic Surgery

Invited Commentary The Annals of Thoracic Surgery

Outcomes of Minimally Invasive Valve Surgery Versus Median Sternotomy in Patients Age 75 Years or Greater Joseph Lamelas, MD, Alejandro Sarria, MD, Orlando.

An Easy and Useful Exposure Technique Using a Malleable Ring for the Distal Anastomosis in Total Arch Replacement Shigehiko Tokunaga, MD, Shota Yasuda,

A New Technique for Dissection of the Pulmonary Vessels

Coronary Artery Revascularization After Chest Wall Reconstruction With Rectus Abdominis Myocutaneous Flap Julio C. Vasquez, MD, Frank A. Baciewicz, MD

“Transitions” for Cardiothoracic Surgeons Now Listed on the Web:

Catheter-Based Endoscopic Bypass Grafting: An Experimental Feasibility Study Stephan Jacobs, MD, David Holzhey, MD, Hubert Stein, BS, BME, Friedrich W.

Sequential Bypass Grafting on the Beating Heart: Blood Flow Characteristics Marek Gwozdziewicz, MD, PhD, Petr Němec, MD, PhD, Martin Šimek, MD, Roman.

Type B Aortic Dissection After the Use of Tadalafil

The Impact of New Technology on Cardiothoracic Surgical Practice

Invited commentary The Annals of Thoracic Surgery

Harvey Edward Garrett, MD, Bradley A. Wolf, MD

How I Teach Hemi-Arch Replacement

Presentation transcript:

Roux-en-Y Diversion for Intractable Reflux After Esophagectomy Xavier Benoit D'Journo, MD, Jocelyne Martin, MD, Louis Gaboury, MD, Pasquale Ferraro, MD, André Duranceau, MD The Annals of Thoracic Surgery Volume 86, Issue 5, Pages 1646-1652 (November 2008) DOI: 10.1016/j.athoracsur.2008.06.054 Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Roux-en-Y reconstruction in patients with substernal transposition. (A) Esophagectomy with substernal reconstruction and left cervical anastomosis. The exposure is by a partial or complete sternotomy. The dissection locates the pyloroduodenal junction and care is taken to identify and preserve the right gastroepiploic blood supply to the stomach. (B) A suprapapillary closure and transection of the duodenum is achieved. The antrectomy is completed by progressive dissection of the distal third of the stomach close to its wall with ligation of antral vessels from the gastroepiploic artery. The jejunum is transected 15 cm distal to the ligament of Treitz to preserve the first mesenteric loop. Preparation for a Roux-en-Y reconstruction is completed. (C) The distal end of the transected jejunum is brought through the transverse mesocolon and anastomosed to the stomach as an end-to-side gastrojejunostomy. The jejunojejunostomy of the Roux-en-Y limb is completed 60-cm below the gastrojejunostomy. The Annals of Thoracic Surgery 2008 86, 1646-1652DOI: (10.1016/j.athoracsur.2008.06.054) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Roux-en-Y reconstruction in patients with prevertebral transposition. (A) Esophagectomy with a prevertebral reconstruction and right chest anastomosis (Ivor-Lewis). The exposure is by laparotomy and transhiatal dissection. (B) Transection of the duodenum below the pylorus with a 60-mm linear stapler affords biliopancreatic diversion. Pylorectomy with distal antrectomy is completed. The jejunum is transected 15 cm below the ligament of Treitz. The distal end of the divided jejunum is brought through the transverse mesocolon, and the antrojejunostomy is created. (C) The 60-cm Roux-en-Y diversion is completed by the distal jejunojejunostomy. The Annals of Thoracic Surgery 2008 86, 1646-1652DOI: (10.1016/j.athoracsur.2008.06.054) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions