Complete mechanical cervical anastomosis using a narrow gastric tube after esophagectomy for cancer.
OBJECTIVE
Fibrous stenosis of the esophagogastric cervical anastomosis remains a significant complication occurring in up to one-third of cases. Trying to reduce the incidence of this complication, we describe our technique of cervical esophagogastric anastomosis using endoscopic linear stapler which seems to reduce the incidence of fibrous stricture formation after resection of esophageal cancer.


METHODS
Between March 2000 and June 2003, 26 patients (15 males and 11 females) underwent esophagectomy using tubulized stomach for reconstruction. Cervical esophagogastric anastomosis using linear endoscopic stapler was performed in all cases. The occurrence of post-operative anastomotic leak and development of anastomotic stricture were recorded and analyzed.


RESULTS
All patients survived esophagectomy and were available for post-operative follow-up. Anastomotic leak developed in one case. No patient developed fibrous stenosis that required dilatation therapy.


CONCLUSIONS
Complete mechanical esophagogastric anastomosis, using endoscopic linear stapler is effective and safe, even when a narrow gastric tube is used as esophageal substitute. This technique seems superior to other techniques to reduce the incidence of post-operative anastomotic complications.
De Giacomo
Tiziano
T
Division of Thoracic Surgery, Department of Surgery and Transplantation P. Stefanini, University of Rome La Sapienza, Policlinico Umberto I, V. le Policlinico 155, 00164 Rome, Italy. tiziano.degiacomo@tin.it
Francioni
Federico
F
Venuta
Federico
F
Trentino
Paolo
P
Moretti
Marco
M
Rendina
Erino A
EA
Coloni
Giorgio F
GF
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D004938:Esophageal Neoplasms / Q000601:surgery*; D004940:Esophageal Stenosis / Q000517:prevention & control; D016629:Esophagectomy; D004944:Esophagoplasty / Q000379:methods*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000601:surgery*; D013528:Surgical Staplers