An Isoperistaltic Gastric Tube:  New Method of Esophageal Replacement

Mikio Yamagishi, MD; Noritsugu Ikeda, MD; Toshio Yonemoto, MD
Arch Surg. 1970;100(6):689-692. doi:10.1001/archsurg.1970.01340240057012.
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In a new method of esophageal replacement or bypass, an isoperistaltic gastric tube isolated from the greater curvature side of the stomach is used as a substitute for the esophagus. The tube can be shifted to a place of considerable distance and its oral end can be anastomosed to the cervical esophagus without tension even if the subcutaneous route is chosen. This is possible because it has a long vascular pedicle made from the right gastroepiploic vessels. This procedure has been done, without operative deaths, on 17 patients with cancer of the thoracic middle or upper third of the esophagus. Radical resection of the cancer was performed on two of these patients. Leakage in the neck occurred in two cases; however, it healed soon in both cases. None complained of regurgitation of gastric juice.


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