Esophagogastric Anastomosis Stricture After a Cervical Fistula: Long Term Complication After the McKeown Procedure Sternotomy Approach: Anastomosis Resection

Background Anastomotic stricture after anastomotic leakage is a common long term complication after mckeown procedure. It can be resolved by endoscopic dilations on most occasions. However, if endoscopic aproach fail, we have to solve the estenosis with a surgery procedure. This type of reintervention could be a really hard aproach due to an intense fibrosis and anatomical layer destructuring. In this video, we show a initial cervical approach to do a anastomosis resection and reanastomosis. However, due to the intense fibrosis and the difficulty in dissecting the gastric plasty from the sternal table, the incision had to be extended and a partial sternotomy was performed. With this approach, we can see the gastric plasty, making the dissection. The we can perform a new esophagus gastric anastomosis safety. In conclusion, partial sternotomy allows us to visualize the gastric plasty and perform the dissection safety making a tensión free anastomosis. https://we.tl/t-6MTce26lI1