Modified Oesophago-Gastric Dissociation (M-OGD) — a technical modification

Coletta, R; Mussi, E; Bianchi, A; Morabito, A

Abstract

Adhesions and fibrosis following failed primary surgery for severe gastro-oesophageal reflux (GOR) in neurologically impaired children (NI) can render mobilization of the lower oesophagus and oesophago-jejunal anastomosis a technically demanding exercise both at open surgery and laparoscopy. This paper presents the Modified Oesophago-Gastric Dissociation (M-OGD) as a less complex technical modification of the original Total Oesophago-Gastric Dissociation (TOGD). The stomach is detached from the oesophago-gastric junction with an articulated 5-mm stapler, leaving a 5-mm strip of stomach attached to the oesophagus. An end-to-side isoperistaltic oesophago-jejunostomy is created between the gastric stump and the isoperistaltic jejunal Roux loop. A jejuno-jejunal anastomosis restores bowel continuity. Between May 2018 and February 2020, M-OGD was performed on 3 NI patients with a weight of 9–27.3 kg (median = 14 kg). Median age at surgery was 60 months (18–180), median surgical time 170 min (146–280), median re-feeding time was 3 days (2–5), and median length of stay was 20 days (11–25). All patients healed primarily and after a median follow-up of 3 months, there were no problems related to the oesophago-jejunal anastomosis. M-OGD reduces the difficulties of redo oesophageal surgery following failed anti-reflux procedures, with a safer oesophago-jejunal anastomosis and a good long-term outcome.

Citation

Coletta, R., Mussi, E., Bianchi, A., & Morabito, A. (2021). Modified Oesophago-Gastric Dissociation (M-OGD) — a technical modification. Updates in Surgery, 73(2), 775-778. https://doi.org/10.1007/s13304-020-00934-z

• Journal Article Type: Article
• Acceptance Date: Nov 15, 2020
• Online Publication Date: Dec 3, 2020
• Publication Date: Apr 1, 2021
• Deposit Date: Jan 7, 2021
• Publicly Available Date: Jan 7, 2021
• Journal: Updates in Surgery
• Print ISSN: 2038-131X
• Electronic ISSN: 2038-3312
• Publisher: Springer Verlag
• Volume: 73
• Issue: 2
• Pages: 775-778
• DOI: https://doi.org/10.1007/s13304-020-00934-z
• Publisher URL: https://doi.org/10.1007/s13304-020-00934-z
• Related Public URLs: http://link.springer.com/journal/13304