Advanced Surgical Triumph In Pune: Patient Survives Esophagectomy With Gastric Pull-Up Surgery At YCMH In Pimpri
Advanced Surgical Triumph In Pune: Patient Survives Esophagectomy With Gastric Pull-Up Surgery At YCMH In Pimpri
Pimpri Chinchwad, Maharashtra: A 39-year-old patient, successfully underwent a high-risk VATS (Video Assisted Thoracoscopic Surgery) esophagectomy with laparoscopic gastric pull-up surgery at YCMH, Pimpri showcasing a remarkable blend of medical expertise and human resilience.
The patient had a tragic history of corrosive esophageal injury due to consumption of chemicals a year back on 31st January 2024. The chemical led to formation of strictures (narrowing) in his food pipe (oesophagus) which led to difficulty in eating. The patient also had injuries to the adjacent windpipe (trachea) which caused difficulty in breathing. Following this the patient had to undergo a multitude of surgeries which included 3 endoscopic dilatations for esophageal strictures, 5 sessions of endoscopic tracheal granulations removal as well as crico-tracheal resection and anastomosis with a permanent tracheostomy in a span of just 12 months with minimal resolution of symptoms. The patient would develop complaints of difficulty in eating within just 2 weeks of treatment. These numerous visits to the hospital took a toll on the patient’s health as well as the family’s economic and emotional reserve.
The treatments were expensive, and the patient could not work because of his health which led to him being a burden on his family. Not only was the patient financially drained but the repeated treatments also deteriorated the patient’s health and led to decreased immunity and nutritional deficiencies. The endoscopic dilatations of his oesophagus were also associated with the risk of perforation and subsequent death. The patient as well as his family showed extreme endurance and resilience with a lot of patience and the patient subsequently came to YCMH after being financially drained and being rejected from other hospitals due to the high risk associated with the requisite surgery.
The surgical team, led by Dr Santosh Thorat (HOD of General Surgery) and Dr Anand Zingade (Associate Professor), included Dr Deepak Patil (plastic and reconstructive surgeon), Dr Ishwar Patil, Dr Akshay Mhase, Dr Harshavardhan Rokde, Dr Swapnil Patil, Dr Isha Bhujbal, Dr Naresh Balegar executed the esophagectomy with meticulous precision. This complex procedure involved the resection of the oesophagus with VATS (Video Assisted Thoracoscopic Surgery) and Laparoscopic methods followed by a gastric pull-up, where the stomach was mobilized and repositioned to restore continuity of the digestive tract. The surgery, lasting approximately 15 hours, required extensive preoperative planning and intraoperative coordination.
Esophagectomy is one of the most challenging surgeries, often associated with a high complication rate. The gastric pull-up technique, although technically demanding, offers a viable option for restoring oesophageal continuity, particularly in cases where other reconstructive methods are not feasible.
“Due to availability of Ultra-Modern 4K Endoscopic system with most advanced imaging technology in the form of ICG capabilities, the surgeons were able to ascertain the adequacy of blood flow to the newly created gastric conduit for esophageal replacement with confidence rather than depending on hope. The 4K Ultra- Modern Endoscopic System gives additional benefit of reduced blood loss, early return to routine activities and almost no pain in post operative period giving excellent acceptance from patient’s perspective ˮ said Dr Santosh Thorat.
“The surgery was challenging but we dealt with it successfully all due to the combined efforts of surgeons, anaesthetists, nursing staff and other support staff in the hospital” said Dr Deepak Patil.
Postoperative care for esophagectomy patients is critical. XYZ was closely monitored in the intensive care unit (ICU) for 1 week for potential complications including anastomotic leaks, respiratory issues, nutritional challenges, and surgical site infections.
“The successful outcome in this case highlights the importance of advanced instruments and skilled surgeons available at YCMH, which makes it capable of managing such cases with excellent results,” emphasized Dr Rajendra Wabale, Dean of PGI YCMH.
The case of XYZ serves as a beacon of hope for patients battling esophageal diseases, emphasizing the potential for positive outcomes even in the face of complex surgical challenges.
