[Technical considerations on 222 cases of esophageal anastomosis using a stapler].
The Authors report their experience with 222 esophagoenteric anastomoses, performed in 211 cases for malignant neoplasms (middle and lower third) of the esophagus or stomach. Particularly, they have performed 4 Sujura operations, 31 esophagogastric, 4 esophagocolic, 183 esophagojejunal anastomoses utilizing SPTU, ILS and EEA circular stapler. GIA was used in the preparation of the stomach before esophagogastroplasty. Mortality rate of the manual period (1970-1980: 114 cases operated) was 14.5% versus 2.2% of the stapling period (1981-1987: 222 cases operated). From the technical point of view reasons of the superiority of stapled technique are discussed and summarized as follows: 1) space not favourable for handsewn anastomoses; 2) stapled technique allows the surgeon to save anastomoses vascularization; 3) the stapler performs the suture simultaneously so to reduce tensile strength on the anastomoses and the fragile esophageal wall especially; 4) stapled agraphes are fixed in three points vs. the two points of the handsewn stitches.
Liboni
A
A
Zamboni
P
P
Mari
C
C
Uzzau
A
A
Salomoni
C
C
Brunelli
G
G
Buccoliero
F
F
Donini
I
I
D000714:Anastomosis, Surgical / Q000295:instrumentation; D013505:Digestive System Surgical Procedures; D004947:Esophagus / Q000601:surgery*; D006801:Humans; D013528:Surgical Staplers
Considerazioni tecniche su 222 casi di anastomosi esofagee con stapler.