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Maintaining sufficient blood flow to the gastric tube after a subtotal esophagectomy for esophageal cancer is crucial for decreasing the esophagogastric anastomotic leakage. After subtotal esophagectomy for esophageal cancer, to additionally revascularize the gastric tube using the splenic artery a...nd vein, external carotid artery, and internal jugular vein, the supercharge technique was performed in esophageal reconstruction patients. Operative results of these patients (supercharge group) were retrospectively compared with those of patients not receiving the technique (control group). Both operation time and operative blood loss in the supercharge group were significantly longer and larger than those of the control group. However, the incidence of anastomotic leakage was significantly lower in the supercharge group than in the control group, and a 30-day reduction in the mean postoperative hospital stay was achieved with the supercharge group. This practical supercharge technique could be a breakthrough less to reduce leakage during esophageal anastomosis.
Next to esophagojejunostomy stapling for the reconstruction following total gastrectomy, several silk stitches anchoring the jejunum to endoabdominal fascia are made to restore the function of phrenoesophageal ligament.
anchoring suture reduces the impairment of the anastomotic blood flow that is caused by gravitational tension and so is useful to protect the esophagojejunostomy after total gastrectomy.
We noticed a blue-line in the endometrial cavity between the tubal ostiae after injection of methylene blue (to determine tubal patency). We have seen this “blue-line” even in cases with normal or unicornuate uterus and/or in cases with patent or occluded fallopian tubes(Picture 1). So the be...st explanation of this finding may be the high speed jet or turbulence of dye in the top or the deepest part of endometrial cavity. We simply postulated that the zone which holds the methylene blue is the zone where the flashing dye strikes vertically over there and the dye penatrates into the endometrial epithelium and glands. We used this line as a guide that shows midline during operative hysteroscopy ( especially in cases with septate uterus) and we don’t ecxatly know reason why it occurs. It is necessary to perform histologic, molecular or clinical studies on this subject. It may have a multifactorial aetiology. We performed a prospective case control study and will publish it soon after when we get the results.