Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Gastric conduit ischemia or anastomotic breakdown after esophagectomy with cervical esophagogastrostomy often cause severe complications, such as leakage, necrotic organs, and strictures. Thus, the purpose of this study is the safety and efficacy of endoscopic evaluation about reconstructive organs after esophagectomy. The investigators evaluate endoscopic predictions using classifications in acute phase after esophagogastrostomy.
The development and improvement of thoracoscopic esophagectomy (TE) reduced the severe pulmonary complication after esophagectomy. However, the postoperative complications relative to gastric conduit reconstruction are still common issues after esophagectomy. The ischemia of the proximal portion of the graft predisposes these patients to a high incidence of anastomotic complications after esophagectomy. Less commonly, severe graft ischemia can lead to transmural necrosis. Thus, early diagnosis of ischemic reaction may provide the suitable postoperative management and therapeutic intervention to prevent leakage, strictures and necrosis. Thus, the purpose of this study is the safety and efficacy of endoscopic evaluation about reconstructive organs after esophagectomy. The investigators evaluate endoscopic predictions using classifications in acute phase after esophagogastrostomy.
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Patients after esophagectomy | Diagnostic Test | Endoscopic examinations are performed at 1 and 8 postoperative days. Endoscopic examination is added when abnormal findings are demonstrated. |
| Measure | Description | Time Frame |
|---|---|---|
| The classification of gastric conduit ischemia by endoscopic findings predicts the major complications of gastric conduit (strictures, leakage, necrosis) | From 1 to 29 days after esophagectomy |
| Measure | Description | Time Frame |
|---|---|---|
| Biological examination of the mucosal biopsy of gastric conduit as assessed by the ischemia related RNA copy number | From 1 to 15 days after esophagectomy | |
| Biological examination of the mucosal biopsy of gastric conduit as assessed by the scoring system for immunohistochemical staining |
Not provided
Inclusion Criteria:
- Malignant or end-stage benign esophageal disease. Esophagectomy with reconstruction by a gastric pull-up.
Exclusion Criteria:
- Severe heart failure and pulmonary dysfunction Severe renal and liver dysfunction Allergenic history Pregnancy
Not provided
Not provided
Patients undergo an esophagectomy with reconstruction by a gastric pull-up for malignant or end-stage benign esophageal disease. The patients have a cervical esophagogastrostomy.
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Shinichhiro Kobayashi, M.D. | Nagasaki University Graduate School of Biomedical Sciences | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Nagasaki University Hospital | Nagasaki | 852-8501 | Japan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36648542 | Derived | Kobayashi S, Kanetaka K, Yoneda A, Yamaguchi N, Kobayashi K, Nagata Y, Maruya Y, Yamaguchi S, Hidaka M, Eguchi S. Endoscopic mucosal ischemic index for predicting anastomotic complications after esophagectomy: a prospective cohort study. Langenbecks Arch Surg. 2023 Jan 17;408(1):37. doi: 10.1007/s00423-023-02783-x. |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| ID | Term |
|---|---|
| D004938 | Esophageal Neoplasms |
| D003251 | Constriction, Pathologic |
| D057868 | Anastomotic Leak |
| D007511 | Ischemia |
| ID | Term |
|---|---|
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
Not provided
Not provided
Not provided
Not provided
Not provided
dmpDNA
The scoring system refer to the article entitled a scoring system for immunohistochemical staining: consensus report of the task force for basic research of the European Organization for Research and Treatment of Cancer-Gynaecological Cancer Cooperative Group
| From 1 to 15 days after esophagectomy |
| Biological examination of gastric conduit as assessed by the Mitochondrial DNA copy number | From 1 to 15 days after esophagectomy |
| D006258 |
| Head and Neck Neoplasms |
| D004066 | Digestive System Diseases |
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |