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Esophageal cancer (EC) is the eighth most common cancer and the sixth leading cause of cancer deaths worldwide. Minimally invasive esophagectomy (MIE) is regarded as a safe and effective management for resectable EC. Gastric tube is considered to be an ideal substitute for the resected esophagus, and used for cervical esophagogastric anastomoses for digestive tract reconstruction in MIE. However, the tension at the anastomosed area can not be ignored and may cause cervical anastomotic leakage (CAL) in some cases. Continuous neck flexion is a standard post-operative posture after tracheal resection and reconstruction, and aimed to relieve the anastomotic tension. In this study, the investigators attempt to adopt the maneuver in MIE, and observe its effect on relieving the anastomotic tension and decreasing the incidence of CAL.
After the cervical esophagogastric anastomoses is completed and the skin incision is closed, the patient's occiput will be lifted, and then the neck will be maintained in flexing position by an assistant. The underside of the chin will be fixed to the anterior chest wall with two stout nylon sutures by the surgeon. The neck will be fixed in the neutral flexing position for 7 to 10 days after surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| neck flexion group | Experimental | Patients who fixed in neck flexion position after MIE |
|
| control group | No Intervention | Patients without posture intervention after MIE |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| neck flexion | Procedure | After the cervical esophagogastric anastomoses is completed and the skin incision is closed, the patient's occiput will be lifted, and then the neck will be maintained in flexing position by an assistant. The underside of the chin will be fixed to the anterior chest wall with two stout nylon sutures by the surgeon. The neck will be fixed in the neutral flexing position for 7 to 10 days after surgery. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of post-operative cervical esophagogastric anastomotic leakage | The post-operative cervical esophagogastric anastomotic leakage is defined as a radiological defect at the anastomotic site, or leakage of swallowed fluid (saliva, gastric juice or food residue) out of the drain site or cervical wound. | From the day of operation to hospital discharge (an expected average of 2 weeks) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Kun Li, MD | Contact | +8615023072303 | 023-68757983 | soloonline1981@163.com |
| Jinghai Zhou, MD | Contact | +8613983612263 | 023-68757982 | tmmuzjh@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Kun Li, MD | Daping Hospital and the Research Institute of Surgery of the Third Military Medical University | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Daping Hospital and the Research Institute of Surgery of the Third Military Medical University | Recruiting | Chongqing | Chongqing Municipality | 400042 | China |
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| ID | Term |
|---|---|
| D004938 | Esophageal Neoplasms |
| D057868 | Anastomotic Leak |
| ID | Term |
|---|---|
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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|
| D006258 |
| Head and Neck Neoplasms |
| D004066 | Digestive System Diseases |
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |