Mechanically stapled esophagojejunostomy. Results of a prospective series of 176 cases.
OBJECTIVE
To evaluate the reliability of stapled esophagojejunostomy.


METHODS
We studied a non-selected prospective series of 176 consecutive total gastrectomies (169 cancers, 7 benign pathologies).


RESULTS
Hand-sewn esophagojejunostomy was performed 5 times after failure of the stapled esophagojejunostomy. There were fourteen hospital deaths (8%), and 63 patients (36%) presented complications. There were 5 anastomotic leaks (2.8%) but non were responsible for deaths. In these 5 cases, there had been an incident during construction of the esophagojejunostomy. Such an incident was the only significant risk factor for an anastomotic leak: 17% after an incident and 0% in the absence of an incident (p < 0.001). We observed no cases of anastomotic stricture.


CONCLUSIONS
Stapled esophagojejunostomy is a reliable technique when technical precautions are taken. It is easier to reproduce than hand-sewn esophagojejunostomy and has demonstrated low specific morbidity and no direct mortality.
Pol
B
B
Department of Surgery and Liver Transplantation, Hopital de la Conception, Marseilles.
LeTreut
Y P
YP
Hardwigsen
J
J
Rosset
E
E
Houvenaeghel
G
G
Delpero
J R
JR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004947:Esophagus / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007431:Intraoperative Complications; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D013272:Stomach Diseases / Q000601:surgery; D013274:Stomach Neoplasms / Q000601:surgery; D017792:Surgical Stapling / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D015996:Survival Rate; D017211:Treatment Failure