[Cervical esophagogastric anastomosis evaluation with a mechanical device versus manual suture in patients with advanced megaesophagus].
OBJECTIVE
The aim of the study is to evaluate cervical esophagogastric anastomosis complications between mechanical device versus manual suture.


METHODS
Thirty patients with megaesophagus with grade III/IV submitted to the esophagectomy transmediastinal approach were reviewed with average age from 31 to 68 years. The reconstruction was performed by gastric transposition and with anastomosis in the cervical region. The patients were divided in two groups: A) 15 patients had mechanical suture with the DHC 29 mm device, and B) 15 patients had manual suture in two layers.


RESULTS
Five patients (16.6%) presented pneumonia, and they were managed clinically. Three patients were in group B and two were in group A, and no statistical significance was found. Six patients (20%) presented leakage at the cervical esophagogastric anastomosis; one in group A (6.6%) and five in group B (33.3%), with no statistical significance. Anastomosis leakage with development of stricture occurred in five patients in group B, and in three in group A, as well in other two without leakage complications. All of them were managed successfully with endoscopic dilatation. Statistical evaluation was not significant for this complication between group B (33.3%) and group A (20%). There were no deaths in this study.


CONCLUSIONS
This study showed that mechanical suture is as adequate as manual suture by presenting anastomosis leakage incidence smaller, however, with no statistical significance, and with similar stricture incidence.
Aquino
José Luís Braga de
JL
Faculdade de Nutrição, PUC-Campinas. jlaquino@sigmanet.com.br
Camargo
José Gonzaga Teixeira
JG
Said
Marcelo Manzano
MM
Merhi
Vânia Aparecida Leandro
VA
Maclellan
Kátia Cristina Portero
KC
Palu
Beatriz Frolini
BF
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D004931:Esophageal Achalasia / Q000209:etiology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000601:surgery*; D013536:Suture Techniques / Q000295:instrumentation*