Supercharged TRAM Evaluation in Cervical Esophagogastroplasty After Esophagectomy

Condition(s) studied

Investigational drug(s) / intervention(s)

Supercharged TRAM esophagectomy: Esophagectomy, immediately followed by supercharged esophagogastroplasty. Use the transverse rectus abdominis myocutaneous (TRAM) flap transfers to surgically create a new anastomosis in the left gastroepiploic vessels.

Conventional Esophagectomy: Esophagectomy, immediately followed by an esophagus reconstruction trough esophagogastroplasty.

Study summary

Esophagectomy has high rates of morbidity and mortality, in many cases due to esophagus reconstruction. Anastomotic leakage and fistula are the main esophagectomy complications. Many studies underwent to investigate the cause for anastomotic leakage after esophagectomy, however none of them conclude it is related to surgery or suture technique. However, it seems to be triggered by the ischemia caused after stomach mobilization to esophagus reconstruction, or even tension in the anastomosis.

Considering the post esophagectomy with gastroplasty high morbidity and mortality rates, strategies to create a new vascularization source and decrease anastomotic leakage rates is important. In this study researchers will evaluate whether a TRAM flap transfer supercharged is effective on decrease morbidity related to anastomosis ischemia in patients undergoing esophagectomy.

Eligibility

Primary outcome measure(s)

• Presence and number of post-operatory complications — Until 1 year after Surgery
  surgical wound infection, hematoma, anastomotic leakage, stenosis, chylothorax and clinical complications due to hospitalization
• Mortality — Until 1 year after surgery after surgery
  Patients who and when died

Trial sites (1)

More Instituto do Cancer do Estado de São Paulo trials in Brazil