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Dorsal Track Control (DTC): A Modified Surgical Technique for Atraumatic Handling of the Distal Esophagus in Esophagojejunostomy.
- Source :
-
Journal of gastric cancer [J Gastric Cancer] 2019 Dec; Vol. 19 (4), pp. 473-483. Date of Electronic Publication: 2019 Oct 23. - Publication Year :
- 2019
-
Abstract
- Surgical therapy for adenocarcinoma of the esophagogastric junction II requires distal esophagectomy, in which a transhiatal management of the lower esophagus is critical. The 'dorsal track control' (DTC) maneuver presented here facilitates the atraumatic handling of the distal esophagus, in preparation for a circular-stapled esophagojejunostomy. It is based on a ventral semicircular incision in the distal esophagus, with an intact dorsal wall for traction control of the esophagus. The maneuver facilitates the proper placement of the purse-string suture, up to its tying (around the anvil), thus minimizing the manipulation of the remaining esophagus. Furthermore, the dorsally-exposed inner wall surface of the ventrally-opened esophagus serves as a guiding chute that eases anvil insertion into the esophageal lumen. We performed this novel technique in 21 cases, enabling a safe anastomosis up to 10 cm proximal to the Z-line. No anastomotic insufficiency was observed. The DTC technique improves high transhiatal esophagojejunostomy.<br />Competing Interests: Conflict of Interest: No potential conflict of interest relevant to this article was reported.<br /> (Copyright © 2019. Korean Gastric Cancer Association.)
Details
- Language :
- English
- ISSN :
- 2093-582X
- Volume :
- 19
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of gastric cancer
- Publication Type :
- Academic Journal
- Accession number :
- 31897349
- Full Text :
- https://doi.org/10.5230/jgc.2019.19.e35