A novel intraoperative Esophagus-Sparing Anastomotic Narrowing Revision (ESANR) technique for patients who underwent esophagojejunostomy: three case reports and a review of the literature

Abstract Aim The aim of this study was to introduce the Esophagus-Sparing Anastomotic Narrowing Revision (ESANR) technique for the intraoperative management of anastomotic narrowing and to conduct a literature review to provide an algorithm for the management of narrowing and strictures that may dev...

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Main Authors: Jian Zhou, Zhenhong Wang, Guobiao Chen, Yi Li, Min Cai, Fathima Shifly Pannikkodan, Xiangzhi Qin, Dan Bai, Zhenbing Lv, Lei Gong, Yunhong Tian
Format: Article
Language:English
Published: BMC 2024-12-01
Series:World Journal of Surgical Oncology
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Online Access:https://doi.org/10.1186/s12957-024-03647-4
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author Jian Zhou
Zhenhong Wang
Guobiao Chen
Yi Li
Min Cai
Fathima Shifly Pannikkodan
Xiangzhi Qin
Dan Bai
Zhenbing Lv
Lei Gong
Yunhong Tian
author_facet Jian Zhou
Zhenhong Wang
Guobiao Chen
Yi Li
Min Cai
Fathima Shifly Pannikkodan
Xiangzhi Qin
Dan Bai
Zhenbing Lv
Lei Gong
Yunhong Tian
author_sort Jian Zhou
collection DOAJ
description Abstract Aim The aim of this study was to introduce the Esophagus-Sparing Anastomotic Narrowing Revision (ESANR) technique for the intraoperative management of anastomotic narrowing and to conduct a literature review to provide an algorithm for the management of narrowing and strictures that may develop secondary to esophagojejunostomy. Methods Three patients with anastomotic narrowing during esophagojejunostomy were analyzed between September 2019 and June 2024. The anastomotic narrowing was detected by intraoperative gastroscopy after reconstruction. The ESANR technique was performed for the management of anastomotic narrowing. We conducted a systematic search of PubMed, Embase, and Web of Science databases for studies published up to June 2024 related to the treatment of anastomotic stricture. Data on the number of patients, sex, age, type of anastomosis, treatment, and outcomes were collected. Results The ESANR technique proved effective for the management of anastomotic narrowing in patients who underwent esophagojejunostomy during gastric cancer surgery. No anastomotic stricture or leakage was found following ESANR, and all three patients recovered without complications. 12 studies with a total of 174 patients were analyzed. The management of anastomotic stricture, which included Balloon Dilation (BD), Endoscopic Incision Therapy (EIT), stent placement, Endoscopic combination therapy (Needle-Knife stricturotomy NKS, Balloon Dilation with Triamcinolone Injection TAC), and re-do laparoscopic esophagojejunostomy. Conclusions In conclusion, the ESANR technique demonstrates potential advantages in addressing anastomotic narrowing in esophagojejunostomy. However, further clinical data and analyses are necessary to verify its effectiveness and establish robust statistical support.
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spelling doaj-art-99a400f28644427db0984deebfe2df892025-08-20T02:46:00ZengBMCWorld Journal of Surgical Oncology1477-78192024-12-0122111310.1186/s12957-024-03647-4A novel intraoperative Esophagus-Sparing Anastomotic Narrowing Revision (ESANR) technique for patients who underwent esophagojejunostomy: three case reports and a review of the literatureJian Zhou0Zhenhong Wang1Guobiao Chen2Yi Li3Min Cai4Fathima Shifly Pannikkodan5Xiangzhi Qin6Dan Bai7Zhenbing Lv8Lei Gong9Yunhong Tian10Department of General Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University)Department of General Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University)Department of General Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University)Department of Plastic Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University)Department of Stomatology, North Sichuan Medical College (University)Department of General Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University)Department of General Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University)Department of General Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University)Department of General Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University)Department of General Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University)Department of General Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University)Abstract Aim The aim of this study was to introduce the Esophagus-Sparing Anastomotic Narrowing Revision (ESANR) technique for the intraoperative management of anastomotic narrowing and to conduct a literature review to provide an algorithm for the management of narrowing and strictures that may develop secondary to esophagojejunostomy. Methods Three patients with anastomotic narrowing during esophagojejunostomy were analyzed between September 2019 and June 2024. The anastomotic narrowing was detected by intraoperative gastroscopy after reconstruction. The ESANR technique was performed for the management of anastomotic narrowing. We conducted a systematic search of PubMed, Embase, and Web of Science databases for studies published up to June 2024 related to the treatment of anastomotic stricture. Data on the number of patients, sex, age, type of anastomosis, treatment, and outcomes were collected. Results The ESANR technique proved effective for the management of anastomotic narrowing in patients who underwent esophagojejunostomy during gastric cancer surgery. No anastomotic stricture or leakage was found following ESANR, and all three patients recovered without complications. 12 studies with a total of 174 patients were analyzed. The management of anastomotic stricture, which included Balloon Dilation (BD), Endoscopic Incision Therapy (EIT), stent placement, Endoscopic combination therapy (Needle-Knife stricturotomy NKS, Balloon Dilation with Triamcinolone Injection TAC), and re-do laparoscopic esophagojejunostomy. Conclusions In conclusion, the ESANR technique demonstrates potential advantages in addressing anastomotic narrowing in esophagojejunostomy. However, further clinical data and analyses are necessary to verify its effectiveness and establish robust statistical support.https://doi.org/10.1186/s12957-024-03647-4Anastomotic narrowingGastric cancerEsophagojejunostomyEsophagus-sparingRevision
spellingShingle Jian Zhou
Zhenhong Wang
Guobiao Chen
Yi Li
Min Cai
Fathima Shifly Pannikkodan
Xiangzhi Qin
Dan Bai
Zhenbing Lv
Lei Gong
Yunhong Tian
A novel intraoperative Esophagus-Sparing Anastomotic Narrowing Revision (ESANR) technique for patients who underwent esophagojejunostomy: three case reports and a review of the literature
World Journal of Surgical Oncology
Anastomotic narrowing
Gastric cancer
Esophagojejunostomy
Esophagus-sparing
Revision
title A novel intraoperative Esophagus-Sparing Anastomotic Narrowing Revision (ESANR) technique for patients who underwent esophagojejunostomy: three case reports and a review of the literature
title_full A novel intraoperative Esophagus-Sparing Anastomotic Narrowing Revision (ESANR) technique for patients who underwent esophagojejunostomy: three case reports and a review of the literature
title_fullStr A novel intraoperative Esophagus-Sparing Anastomotic Narrowing Revision (ESANR) technique for patients who underwent esophagojejunostomy: three case reports and a review of the literature
title_full_unstemmed A novel intraoperative Esophagus-Sparing Anastomotic Narrowing Revision (ESANR) technique for patients who underwent esophagojejunostomy: three case reports and a review of the literature
title_short A novel intraoperative Esophagus-Sparing Anastomotic Narrowing Revision (ESANR) technique for patients who underwent esophagojejunostomy: three case reports and a review of the literature
title_sort novel intraoperative esophagus sparing anastomotic narrowing revision esanr technique for patients who underwent esophagojejunostomy three case reports and a review of the literature
topic Anastomotic narrowing
Gastric cancer
Esophagojejunostomy
Esophagus-sparing
Revision
url https://doi.org/10.1186/s12957-024-03647-4
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