[Mechanical reconstruction after total gastrectomy. Analysis of results].
BACKGROUND
Stapling devices introduction in gastroesophageal surgery has allowed better results.


METHODS
An analysis is made of a consecutive series of 108 patients operated on with total gastrectomy and mechanical esophagojejunostomy for gastric neoplasm, in the last decade (1984-1995).


RESULTS
The incidence of anastomotic clinical leakage was 2.4% with a perioperative mortality of 0.9% (1 patient) while the incidence of stenosis, treated in every patient with endoscopic dilatation, was 3.2%. These data are in accordance with previous reports. After an accurate analysis of the factors influencing the complication rate pointed out that in most of the cases a technical error in the anastomosis confection is present.


CONCLUSIONS
The conclusion is drawn that the use of stapling devices in gastroesophageal surgery represents an elective indication. Nevertheless it is mandatory to respect the principles of visceral mechanical anastomosis after an adequate training.
Santini
L
L
Istituto di Semeiotica Chirurgica, II Università degli Studi, Napoli.
Conzo
G
G
Caracò
C
C
Esposito
B
B
De Stefano
P
P
D'Ardis
A
A
D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D007890:Leiomyosarcoma / Q000601:surgery*; D008223:Lymphoma / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013274:Stomach Neoplasms / Q000601:surgery*; D013537:Sutures