The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Feb 2000
Comparative StudyEvaluation and outcome of different surgical techniques for postintubation tracheoesophageal fistulas.
We evaluated the outcome of different surgical techniques for postintubation tracheoesophageal fistula. ⋯ Postintubation tracheoesophageal fistula is usually best treated with tracheal or laryngotracheal resection and anastomosis with primary esophageal closure even in the absence of tracheal damage.
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J. Thorac. Cardiovasc. Surg. · Feb 2000
Comparative StudyEliminating the cervical esophagogastric anastomotic leak with a side-to-side stapled anastomosis.
Although the acute postoperative complications of a cervical esophagogastric anastomosis are less than those with an intrathoracic esophageal anastomosis, the long-term sequelae of a cervical anastomotic leak are not as minor as initially reported. Nearly 50% of cervical anastomotic leaks result in an anastomotic stricture, and the subsequent need for chronic dilatations negates the merits of an operation intended to restore comfortable swallowing. ⋯ Construction of the cervical esophagogastric anastomosis with a side-to-side stapled anastomosis greatly reduces the frequency of anastomotic leaks and later strictures. The side-to-side stapled anastomosis is a major technical advance in the progression of refinements of transhiatal esophagectomy and a cervical esophagogastric anastomosis.
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J. Thorac. Cardiovasc. Surg. · Feb 2000
Multicenter Study Comparative Study Clinical TrialRevision of previous Fontan connections to total extracardiac cavopulmonary anastomosis: A multicenter experience.
Conversion to total extracardiac cavopulmonary anastomosis is an option for managing patients with dysfunction of a prior Fontan connection. ⋯ Conversion of a failing Fontan connection to extracardiac cavopulmonary connection can be achieved with low morbidity and mortality. Optimally, revision should be undertaken early in symptomatic patients before irreversible ventricular failure ensues.