The Experts below are selected from a list of 492 Experts worldwide ranked by ideXlab platform

Woo Jin Hyung - One of the best experts on this subject based on the ideXlab platform.

Michihiro Yamamoto - One of the best experts on this subject based on the ideXlab platform.

  • linear or circular stapler a propensity score matched multicenter analysis of intracorporeal Esophagojejunostomy following totally laparoscopic total gastrectomy
    Surgical Endoscopy and Other Interventional Techniques, 2020
    Co-Authors: Katsuhiro Murakami, Kazutaka Obama, Shigeru Tsunoda, Shigeo Hisamori, Tatsuto Nishigori, Koya Hida, Seiichiro Kanaya, Seiji Satoh, Dai Manaka, Michihiro Yamamoto
    Abstract:

    Presently, there is no consensus as to what procedure of intracorporeal Esophagojejunostomy (EJS) in totally laparoscopic total gastrectomy (TLTG) is best to reduce postoperative complications. The aim of this study was to demonstrate the superiority of linear stapled reconstruction in terms of anastomotic-related complications for EJS in TLTG. We collected data on 829 consecutive gastric cancer patients who underwent TLTG reconstructed by the Roux-en-Y method with radical lymphadenectomy between January 2010 and December 2016 in 13 hospitals. The patients were divided into two groups according to reconstruction method and matched by propensity score. Postoperative EJS-related complications were compared between the linear stapler (LS) and the circular stapler (CS) groups. After matching, data from 196 patients in each group were analyzed. The overall incidence of EJS-related complications was significantly lower in the LS group than in the CS group (4.1% vs. 11.7%, p = 0.008). The incidence of EJS anastomotic stenosis during the first year after surgery was significantly lower in the LS group than in the CS group (1.5% vs. 7.1%, p = 0.011). The incidence of EJS bleeding did not differ significantly between the groups, although no bleeding was observed in the LS group (0% vs. 2.0%, p = 0.123). The incidence of EJS leakage did not differ significantly between the groups (2.6% vs. 3.6%, p = 0.771). The use of linear stapled reconstruction is safer than the use of circular stapled reconstruction for intracorporeal EJS in TLTG because of its lower risks of stenosis.

Rhonda F Souza - One of the best experts on this subject based on the ideXlab platform.

  • columnar lined esophagus develops via wound repair in a surgical model of reflux esophagitis
    Cellular and molecular gastroenterology and hepatology, 2018
    Co-Authors: Agoston T Agoston, Thai H Pham, Robert D Odze, David H Wang, Kiron M Das, Stuart J Spechler, Rhonda F Souza
    Abstract:

    Background & Aims After Esophagojejunostomy, rodents develop reflux esophagitis and a columnar-lined esophagus with features of Barrett’s metaplasia. This rodent columnar-lined esophagus has been proposed to develop from cellular reprogramming of progenitor cells, but studies on early columnar-lined esophagus development are lacking. We performed a systematic, histologic, and immunophenotypic analysis of columnar-lined esophagus development in rats after Esophagojejunostomy. Methods At various times after Esophagojejunostomy in 52 rats, the esophagus was removed and tissue sections were evaluated for type, location, and length of columnar lining. Molecular characteristics were evaluated by immunohistochemistry and immunofluorescence. Results At week 2, ulceration was seen in esophageal squamous epithelium, starting distally at the Esophagojejunostomy anastomosis. Re-epithelialization of the distal ulcer segment occurred via proliferation and expansion of immature-appearing glands budding directly off jejunal crypts, characteristic of wound healing. The columnar-lined esophagus's immunoprofile was similar to jejunal crypt epithelium, and columnar-lined esophagus length increased significantly from 0.15 mm (±0.1 SEM) at 2 weeks to 5.22 mm (±0.37) at 32 weeks. Neoglands were found within esophageal ulcer beds, and spindle-shaped cells expressing epithelial-mesenchymal transition markers were found at the columnar-lined esophagus's leading edge. Only proliferative squamous epithelium was found at the proximal ulcer border. Conclusions After Esophagojejunostomy in rats, metaplastic columnar-lined esophagus develops via a wound healing process that does not appear to involve cellular reprogramming of progenitor cells. This process involves EMT-associated migration of jejunal cells into the esophagus, where they likely have a competitive advantage over squamous cells in the setting of ongoing gastroesophageal reflux disease.

  • Columnar-Lined Esophagus Develops via Wound Repair in a Surgical Model of Reflux EsophagitisSummary
    'Elsevier BV', 2018
    Co-Authors: Agoston T Agoston, Thai H Pham, Robert D Odze, David H Wang, Kiron M Das, Stuart J Spechler, Rhonda F Souza
    Abstract:

    Background & Aims: After Esophagojejunostomy, rodents develop reflux esophagitis and a columnar-lined esophagus with features of Barrett’s metaplasia. This rodent columnar-lined esophagus has been proposed to develop from cellular reprogramming of progenitor cells, but studies on early columnar-lined esophagus development are lacking. We performed a systematic, histologic, and immunophenotypic analysis of columnar-lined esophagus development in rats after Esophagojejunostomy. Methods: At various times after Esophagojejunostomy in 52 rats, the esophagus was removed and tissue sections were evaluated for type, location, and length of columnar lining. Molecular characteristics were evaluated by immunohistochemistry and immunofluorescence. Results: At week 2, ulceration was seen in esophageal squamous epithelium, starting distally at the Esophagojejunostomy anastomosis. Re-epithelialization of the distal ulcer segment occurred via proliferation and expansion of immature-appearing glands budding directly off jejunal crypts, characteristic of wound healing. The columnar-lined esophagus's immunoprofile was similar to jejunal crypt epithelium, and columnar-lined esophagus length increased significantly from 0.15 mm (±0.1 SEM) at 2 weeks to 5.22 mm (±0.37) at 32 weeks. Neoglands were found within esophageal ulcer beds, and spindle-shaped cells expressing epithelial-mesenchymal transition markers were found at the columnar-lined esophagus's leading edge. Only proliferative squamous epithelium was found at the proximal ulcer border. Conclusions: After Esophagojejunostomy in rats, metaplastic columnar-lined esophagus develops via a wound healing process that does not appear to involve cellular reprogramming of progenitor cells. This process involves EMT-associated migration of jejunal cells into the esophagus, where they likely have a competitive advantage over squamous cells in the setting of ongoing gastroesophageal reflux disease. Keywords: Gastroesophageal Reflux, Barrett’s Esophagus, Epithelial-Mesenchymal Transitio

Tinghan Yang - One of the best experts on this subject based on the ideXlab platform.

  • transabdominal and transhiatal esophagogastrostomy or Esophagojejunostomy using novel double stapling technique
    Chinese Journal of Gastrointestinal Surgery, 2012
    Co-Authors: Ziqiang Wang, Wenjian Meng, Xiangbing Deng, Yuanchuan Zhang, Mingtian Wei, Tinghan Yang
    Abstract:

    Objective To explore the techniques of esophagogastrostomy or Esophagojejunostomy in the mediastinum through the abdomen and hiatus after extended proximal gastectomy or total gastrectomy.Methods From May 2010 to January 2012,15 patients with esophagogastric junction carcinoma underwent open transhiatal extended gastrostomy or total gastrectomy.After full mobilization,the anvil was reversely introdunced into the esophagus and the esophagus was transected with curved stapler,The rod of the anvil was then pulled out with a stitch to complete esophagogastrostomy after proximal gastrectomy (n=9) or Esophagojejunostomy after total gastrectomy (n =6).Results The anastomosis was successfully performed in all the patients.The mean operation time was (185.5±13.1)min.The mean operation time for anastomosis was (42.0±8.6) min.The mean estimated blood loss was (106.7±34.9) ml.The proximal resection margin was (4.4±1.2) cm.All the margins were negative for residual cancer.There was no postoperative death or fistula.During the follow up,there was one case of anastomotic stenosis which was successfully managed by endoscopic balloon dilatation.Conculsions Esophagogastrostomy or Esophagojejunostomy can be safely performed with double stapling technique including reverse anvil introduction and curved stapling transection of the esophagus.It is an ideal technique for anastomosis after extended gastrectomy for esophagogastric junction carcinoma. Key words: Esophagogastric junction carcinoma;  Extended gastrectomy;  Double stapling technique;  Digestive tract reconstruction

Jong Jae Park - One of the best experts on this subject based on the ideXlab platform.

  • Efficacy of the Over-the-Scope Clip System for Treatment of Gastrointestinal Fistulas, Leaks, and Perforations: A Korean Multi-Center Study
    Hoon Jai Chun, 2018
    Co-Authors: Hang Lak Lee, Jong Jae Park, Joo Young Cho, Jun-hyung Cho, Chan Gyoo Kim, Seong Hwan Kim, Joung-ho Han
    Abstract:

    Background/Aims Currently, a new over-the-scope clip (OTSC) system has been introduced. This system has been used for gastrointestinal perforations and fistulas in other countries. The aim of our study is to examine the therapeutic success rate of endoscopic treatment using the OTSC system in Korea. Methods This was a multicenter prospective study. A total of seven endoscopists at seven centers performed this procedure. Results A total of 19 patients were included, with gastrointestinal leakages from anastomosis sites, fistulas, or esophageal perforations due to Boerhaave’s syndrome. Among these, there were three gastrojejunostomy sites, three Esophagojejunostomy sites, four esophagogastrostomy sites, one esophagocolonostomy site, one jejuno-jejunal site, two endoscopic full thickness resection site closures, one Boerhaave’s syndrome, two esophago-bronchial fistulas, one gastrocolonic fistula, and one colonopseudocyst fistula. The size of the leakage ranged from 5 to 30 mm. The median procedure time was 16 min. All cases were technically successful. Complete closure of the leak was achieved in 14 of 19 patients using OTSC alone. Conclusions The OTSC system is a safe and effective method for the management of gastrointestinal leakage, especially in cases of anastomotic leakage after surgery

  • efficacy of the over the scope clip system for treatment of gastrointestinal fistulas leaks and perforations a korean multi center study
    Clinical Endoscopy, 2017
    Co-Authors: Jong Jae Park
    Abstract:

    Currently, a new over-the-scope clip (OTSC) system has been introduced. This system has been used for gastrointestinal perforations and fistulas in other countries. The aim of our study is to examine the therapeutic success rate of endoscopic treatment using the OTSC system in Korea.This was a multicenter prospective study. A total of seven endoscopists at seven centers performed this procedure.A total of 19 patients were included, with gastrointestinal leakages from anastomosis sites, fistulas, or esophageal perforations due to Boerhaave's syndrome. Among these, there were three gastrojejunostomy sites, three Esophagojejunostomy sites, four esophagogastrostomy sites, one esophagocolonostomy site, one jejuno-jejunal site, two endoscopic full thickness resection site closures, one Boerhaave's syndrome, two esophago-bronchial fistulas, one gastrocolonic fistula, and one colonopseudocyst fistula. The size of the leakage ranged from 5 to 30 mm. The median procedure time was 16 min. All cases were technically successful. Complete closure of the leak was achieved in 14 of 19 patients using OTSC alone.The OTSC system is a safe and effective method for the management of gastrointestinal leakage, especially in cases of anastomotic leakage after surgery.