Favorable outcomes with jejunal interposition without vascular anastomosis for esophagectomy in cancer patients: a single-center experience
Abstract Background The standard esophageal replacement for esophageal cancer treatment is a gastric conduit. However, jejunal interposition is often utilized when the stomach is not available. The purpose of this study was to review our experience with this technique, particularly in cases not requ...
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2025-07-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-025-03006-4 |
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| author | Lilan Zhao Yun Ding Juan Zhang Pengjie Tu Zijie He Genglin Li Zhaoxian Lin Xing Lin Zhiwei Lin Zhenlong Zhang Tianxing Guo Lihuan Zhu Wenshu Chen Debin Ou Xiaojie Pan |
| author_facet | Lilan Zhao Yun Ding Juan Zhang Pengjie Tu Zijie He Genglin Li Zhaoxian Lin Xing Lin Zhiwei Lin Zhenlong Zhang Tianxing Guo Lihuan Zhu Wenshu Chen Debin Ou Xiaojie Pan |
| author_sort | Lilan Zhao |
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| description | Abstract Background The standard esophageal replacement for esophageal cancer treatment is a gastric conduit. However, jejunal interposition is often utilized when the stomach is not available. The purpose of this study was to review our experience with this technique, particularly in cases not requiring microvascular anastomosis, and assess surgical outcomes. Methods We retrospectively reviewed the medical records of cancer patients who underwent jejunum interposition at our institution from 2003 to 2020. Data regarding patient characteristics, operative technique, and postoperative outcomes were collected and analyzed. Factors affecting oncologic outcomes were evaluated using Kaplan–Meier estimates and Cox regression. Postoperative conduit function was assessed at 6 months. Results With a median follow-up of 35 months, 122 patients (113 males and 9 females; aged 40 to 86 years) were included. Over half (54.9%, 67/122) had stage III or higher disease. Median operation time was 270 min, and the median drainage time was 8 days. Postoperative complications occurred in 28.7% of patients, with pulmonary infections being the most common. The anastomotic leakage rate was 4.1% (5/122), and the 90-day mortality rate was 5.7%. The overall survival rates at 1, 3, and 5 years were 79.5%, 49.0%, and 35.6%, respectively. The prognosis was mainly correlated with tumor stage and most patients reported good quality of life. Conclusion Our findings suggests that, even without vascular anastomosis, jejunal conduit is a feasible procedure for reconstruction after esophagectomy, resulting in low morbidity and favorable prognosis. |
| format | Article |
| id | doaj-art-eeb543ca0f8943909ee2fe533f6be51f |
| institution | Kabale University |
| issn | 1471-2482 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj-art-eeb543ca0f8943909ee2fe533f6be51f2025-08-20T03:45:40ZengBMCBMC Surgery1471-24822025-07-0125111210.1186/s12893-025-03006-4Favorable outcomes with jejunal interposition without vascular anastomosis for esophagectomy in cancer patients: a single-center experienceLilan Zhao0Yun Ding1Juan Zhang2Pengjie Tu3Zijie He4Genglin Li5Zhaoxian Lin6Xing Lin7Zhiwei Lin8Zhenlong Zhang9Tianxing Guo10Lihuan Zhu11Wenshu Chen12Debin Ou13Xiaojie Pan14Department of Thoracic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial HospitalDepartment of Thoracic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial HospitalDepartment of Thoracic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial HospitalClinical School of Thoracic, Tianjin Medical UniversityDepartment of Thoracic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial HospitalDepartment of Thoracic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial HospitalDepartment of Thoracic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial HospitalDepartment of Thoracic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial HospitalDepartment of Thoracic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial HospitalDepartment of Thoracic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial HospitalDepartment of Thoracic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial HospitalDepartment of Thoracic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial HospitalDepartment of Thoracic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial HospitalDepartment of Thoracic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial HospitalDepartment of Thoracic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial HospitalAbstract Background The standard esophageal replacement for esophageal cancer treatment is a gastric conduit. However, jejunal interposition is often utilized when the stomach is not available. The purpose of this study was to review our experience with this technique, particularly in cases not requiring microvascular anastomosis, and assess surgical outcomes. Methods We retrospectively reviewed the medical records of cancer patients who underwent jejunum interposition at our institution from 2003 to 2020. Data regarding patient characteristics, operative technique, and postoperative outcomes were collected and analyzed. Factors affecting oncologic outcomes were evaluated using Kaplan–Meier estimates and Cox regression. Postoperative conduit function was assessed at 6 months. Results With a median follow-up of 35 months, 122 patients (113 males and 9 females; aged 40 to 86 years) were included. Over half (54.9%, 67/122) had stage III or higher disease. Median operation time was 270 min, and the median drainage time was 8 days. Postoperative complications occurred in 28.7% of patients, with pulmonary infections being the most common. The anastomotic leakage rate was 4.1% (5/122), and the 90-day mortality rate was 5.7%. The overall survival rates at 1, 3, and 5 years were 79.5%, 49.0%, and 35.6%, respectively. The prognosis was mainly correlated with tumor stage and most patients reported good quality of life. Conclusion Our findings suggests that, even without vascular anastomosis, jejunal conduit is a feasible procedure for reconstruction after esophagectomy, resulting in low morbidity and favorable prognosis.https://doi.org/10.1186/s12893-025-03006-4Esophageal cancerCardia cancerJejunal interpositionReconstructionPrognosis |
| spellingShingle | Lilan Zhao Yun Ding Juan Zhang Pengjie Tu Zijie He Genglin Li Zhaoxian Lin Xing Lin Zhiwei Lin Zhenlong Zhang Tianxing Guo Lihuan Zhu Wenshu Chen Debin Ou Xiaojie Pan Favorable outcomes with jejunal interposition without vascular anastomosis for esophagectomy in cancer patients: a single-center experience BMC Surgery Esophageal cancer Cardia cancer Jejunal interposition Reconstruction Prognosis |
| title | Favorable outcomes with jejunal interposition without vascular anastomosis for esophagectomy in cancer patients: a single-center experience |
| title_full | Favorable outcomes with jejunal interposition without vascular anastomosis for esophagectomy in cancer patients: a single-center experience |
| title_fullStr | Favorable outcomes with jejunal interposition without vascular anastomosis for esophagectomy in cancer patients: a single-center experience |
| title_full_unstemmed | Favorable outcomes with jejunal interposition without vascular anastomosis for esophagectomy in cancer patients: a single-center experience |
| title_short | Favorable outcomes with jejunal interposition without vascular anastomosis for esophagectomy in cancer patients: a single-center experience |
| title_sort | favorable outcomes with jejunal interposition without vascular anastomosis for esophagectomy in cancer patients a single center experience |
| topic | Esophageal cancer Cardia cancer Jejunal interposition Reconstruction Prognosis |
| url | https://doi.org/10.1186/s12893-025-03006-4 |
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