Supercharged TRAM Evaluation in Cervical Esophagogastroplasty After Esophagectomy
Instituto do Cancer do Estado de São Paulo
60 participants
Jul 21, 2023
INTERVENTIONAL
Conditions
Summary
Esophagectomy has high rates of morbidity and mortality, in many cases due to esophagus reconstruction. Anastomotic leakage and fistula are the main esophagectomy complications. Many studies underwent to investigate the cause for anastomotic leakage after esophagectomy, however none of them conclude it is related to surgery or suture technique. However, it seems to be triggered by the ischemia caused after stomach mobilization to esophagus reconstruction, or even tension in the anastomosis. Considering the post esophagectomy with gastroplasty high morbidity and mortality rates, strategies to create a new vascularization source and decrease anastomotic leakage rates is important. In this study researchers will evaluate whether a TRAM flap transfer supercharged is effective on decrease morbidity related to anastomosis ischemia in patients undergoing esophagectomy.
Eligibility
Inclusion Criteria2
- Diagnosis of esophageal malignancy cancer;
- Ability to understand and collaborate during treatment;
Exclusion Criteria3
- Previous gastrectomy;
- Previous abdominal surgery with risk of altering stomach vascularization;
- Previous head and neck surgery with risk of alteration of cervical vessels.
Interventions
Esophagectomy, immediately followed by supercharged esophagogastroplasty. Use the transverse rectus abdominis myocutaneous (TRAM) flap transfers to surgically create a new anastomosis in the left gastroepiploic vessels.
Esophagectomy, immediately followed by an esophagus reconstruction trough esophagogastroplasty.
Locations(1)
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NCT05954702