Reversing Esophageal Discontinuity

Catastrophic esophageal or gastric disruption drive the decision to “disconnect” the esophagus to prevent ongoing mediastinal soilage. The operations used to establish esophageal discontinuity are not standardized and vary widely, the surgeon often focusing on saving the patient’s life, not on how a...

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Bibliographic Details
Published in:Seminars in thoracic and cardiovascular surgery 2007, Vol.19 (1), p.47-55
Main Author: Orringer, Mark B., MD
Format: Article
Language:English
Subjects:
Anastomosis, Surgical - methods
Cardiothoracic Surgery
Colon - injuries
Colon - surgery
Critical Care
Decision Making
Digestive System Surgical Procedures - methods
esophageal discontinuity
Esophageal Diseases - etiology
Esophageal Diseases - surgery
esophageal surgery
Esophagectomy - adverse effects
Esophagostomy - adverse effects
Esophagus - injuries
Esophagus - surgery
Humans
Mediastinitis - etiology
Perioperative Care
Postoperative Complications
Stomach - injuries
Stomach - surgery
Treatment Outcome
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Description
Summary:Catastrophic esophageal or gastric disruption drive the decision to “disconnect” the esophagus to prevent ongoing mediastinal soilage. The operations used to establish esophageal discontinuity are not standardized and vary widely, the surgeon often focusing on saving the patient’s life, not on how alimentary continuity will ultimately be restored. Patients who survive the initial disastrous infectious complications are typically desperate to have further surgery to allow them to eat again. Relatively little is written about the decisions involved in reversing esophageal discontinuity—the timing of the operation, preoperative assessment and preparation, planning and conduct of the operation, and outcome. The nuances of reestablishing alimentary continuity in this disparate patient population are the focus of this article.
ISSN:1043-0679
1532-9488
DOI:10.1053/j.semtcvs.2006.11.004