Gastric elevation

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Gastric pull-up (Engl. Gastric pull-up) means interposition or ascent of mostly a narrow spare esophagus reshaped stomach (gastric tube). It is a procedure for reconstructing the food passage after removal of the esophagus ( esophagectomy ), usually in cancer of the esophagus (esophageal carcinoma). In pediatric surgery , the procedure is used to treat congenital esophageal obstruction ( esophageal atresia ) or the non-existent esophagus ( esophageal aagenesis ).

Routes / ways

There are different "routes" of reconstruction, i. H. different ways where this sleeve stomach can be laid down. The retrosternal route (behind the sternum = breastbone) or the transmediastinal route (i.e. in the area of ​​the original location of the esophagus in the middle layer of the membrane = mediastinum ) is used most frequently .

  • Esophageal resection with gastric elevation after completion of the intrathoracic anastomosis

  • Gastric tube prepared for pulling up

connection

The upturned stomach is connected either in the neck area ("collare esophagogastrostomy") or in the mediastinum ("thoracic esophagogastrostomy") with partial removal of the lower esophagus ( esophageal resection ). Usually machine ("circular stapler"), but also hand-sewn anastomoses are created.

alternative

Colon interposition is an alternative to gastric elevation if the stomach is not available for gastric elevation due to previous surgery (previous surgery on the stomach).

Individual evidence

  1. ↑ B. Adams: Gastroenterology: the reference work for clinics and practice . Ed .: JF Riemann. tape 2 . Georg Thieme Verlag, Stuttgart 2008, ISBN 978-3-13-141201-0 , p. 427 ff .