P183 NEW METHOD OF ESOPHAGO-GASTRO ANASTOMOSIS WITHIN MINIMALLY INVASIVE HYBRID IVOR LEWIS PROCEDURE

Abstract

Abstract Aim Improve the results of surgical treatment of esophageal cancer by developing and implementing a new method for the formation of invagination mechanical esophagogastoanastomosis. Material and methods Reconstruction after esophagectomy together with the reliability of the esophagus-gastric anastomosis (EGA) constitute some of the most important problems in the surgery of the esophagus, because anastomosis leakage is one of the main reasons of lethal surgery. The research included 60 patients who anderwent the minimally invasive hybrid Ivor Lewis procedure for malignant tumors of esophagus in Shalimov National Institute of Surgery and Transplantation (1 group comprised 30 patients with mechanical EGA end-to-side; 2 group comprised 30 patients with invaginated mechanical EGA). The objects for estimation included post-operative mortality as well as the number of post-operative anastomosis complications: the number of EGA leakages in the early post-operative period and the number of post operative strictures in the EGA area three, six and twelve months after the surgery. All patients underwent a course of neoadjuvant chemo/RT in accordance with NCCN guidelines. Data processing was done by means of Statistic - licensed application programs for Windows. Results and discussion Patients belonging to both groups were comparable according to their age, sex, weight, height and surgery duration. Research group did not register a single case of EGA leakage while 2 patients in control group (р<0,05). had the leakage which was stopped by means of “Endovac” system. There were 2 cases of esophagus post-operative strictures which developed 3 months after the surgery in the research group which was less than in the control group which saw 6 cases of strictures of EGA (р<0,05). 6 months after surgery, the number of post-operative strictures increased in both groups, but was lower in the research group and amounted to 4 cases in the research group and 11 cases in the control group (р<0,05). There were 5 cases of esophagus post-operative strictures which developed 12 months after the surgery in the research group which was less than in the control group which saw 13 cases of strictures of EGA (р<0,05). Neither of the groups had any cases of post-operative mortality. Conclusion The study found that invaginated mechanical EGA within minimally invasive hybrid Ivor Lewis procedure reduces EGA leakages as well as EGA benign strictures.