CC BY-NC-ND 4.0 · Thorac Cardiovasc Surg Rep 2018; 07(01): e21-e23
DOI: 10.1055/s-0038-1660833
Case Report: Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Risk-Assessment of Esophageal Surgery: Diagnosis and Treatment of Celiac Trunk Stenosis

Rosa G.M. Lammerts
1   Division of Upper GI Surgery, Department of Surgery, Ziekenhuisgroep Twente, Almelo, Overijssel, The Netherlands
2   Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands
,
Marc J. van Det
1   Division of Upper GI Surgery, Department of Surgery, Ziekenhuisgroep Twente, Almelo, Overijssel, The Netherlands
,
Rob H. Geelkerken
3   Division of Vascular Surgery, Department of Surgery, Medisch Spectrum Twente, Enschede, Overijssel, The Netherlands
,
Ewout A. Kouwenhoven
1   Division of Upper GI Surgery, Department of Surgery, Ziekenhuisgroep Twente, Almelo, Overijssel, The Netherlands
› Author Affiliations
Further Information

Publication History

18 January 2018

03 May 2018

Publication Date:
22 June 2018 (online)

Abstract

Anastomotic leakage of the gastric conduit following surgical treatment of esophageal cancer is a life-threatening complication. An important risk factor associated with anastomotic leakage is calcification of the supplying arteries of the gastric conduit. The patency of calcified splanchnic arteries cannot be assessed on routine computed tomography (CT) scans for esophageal cancer and, as such, in selected patients with known or assumed mesenteric artery disease, additional CT angiography of the abdominal arteries with 1 mm slices is strongly encouraged. If the mesenteric perfusion is compromised in patients with resectable esophageal cancer, angioplasty procedures with stenting of the mesenteric arteries could be performed to prevent possible ischemia of the gastric conduit.

 
  • References

  • 1 Björck M, Koelemay M, Acosta S. , et al; Esvs Guidelines Committee. Editor's choice - management of the diseases of mesenteric arteries and veins: clinical practice guidelines of the European Society of Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2017; 53 (04) 460-510
  • 2 van Rossum PSN, Haverkamp L, Verkooijen HM, van Leeuwen MS, van Hillegersberg R, Ruurda JP. Calcification of arteries supplying the gastric tube: a new risk factor for anastomotic leakage after esophageal surgery. Radiology 2015; 274 (01) 124-132
  • 3 Goense L, van Rossum PSN, Weijs TJ. , et al. Aortic calcification increases the risk of anastomotic leakage after Ivor-Lewis esophagectomy. Ann Thorac Surg 2016; 102 (01) 247-252
  • 4 Kornmann VNN, van Werkum MH, Bollen TL, van Ramshorst B, Boerma D. Compromised visceral circulation does not affect the outcome of colorectal surgery. Surg Today 2014; 44 (07) 1220-1226
  • 5 Mohler III ER, Gornik HL, Gerhard-Herman MD, Misra S, Olin JW, Zierler RE. ACCF/ACR/AIUM/ASE/ASN/ICAVL/SCAI/SCCT/SIR/SVM/SVS 2012 appropriate use criteria for peripheral vascular ultrasound and physiological testing part I: arterial ultrasound and physiological testing. J Am Coll Cardiol 2012; 60 (03) 242-276
  • 6 Bulut T, Oosterhof-Berktas R, Geelkerken RH, Brusse-Keizer M, Stassen EJ, Kolkman JJ. Long-term results of endovascular treatment of atherosclerotic stenoses or occlusions of the coeliac and superior mesenteric artery in patients with mesenteric ischaemia. Eur J Vasc Endovasc Surg 2017; 53 (04) 583-590