[Comparative study of end-to-end cervical esophagogastric anastomosis with or without invagination after esophagectomy for cancer].
OBJECTIVE
To assess the incidence of fistula and stenosis of cervical esophagogastric anastomosis with invagination of the esophageal stump into the gastric tube in esophagectomy for esophagus cancer.


METHODS
Two groups of patients with thoracic and abdominal esophagus cancer undergoing esophagectomy and esophagogastroplasty were studied. Group I comprised 29 patients who underwent cervical esophagogastric anastomosis with invagination of the proximal esophageal stump segment within the stomach, in the period of 1998 to 2007 while Group II was composed of 36 patients submitted to end-to-end cervical esophago-gastric anastomosis without invagination during the period of 1989 to 1997.


RESULTS
In Group I, esophagogastric anastomosis by invagination presented fistula with mild clinical implications in 3 (10.3%) patients, whereas in Group II, fistulas with heavy saliva leaks were observed in 11 (30.5%) patients. The frequency of fistulas was significantly lower in Group I patients (p=0.04) than in Group II. In Group I, fibrotic stenosis of anastomoses occurred in 7 (24.1%) subjects, and 10 patients (27.7%) in Group II evolved with stenosis, while no significant difference (p=0.72) was found between the two groups.


CONCLUSIONS
In esophagectomy for esophagus cancer, cervical esophagogastric anastomosis with invagination presented a lower rate of esophagogastric fistula versus anastomosis without invagination. Stenosis rates in esophagogastric anastomosis proved similar in both approach with or without invagination.
Henriques
Alexandre Cruz
AC
Disciplina do Aparelho Digestivo da Faculdade de Medicina do ABC - São Bernardo do Campo - SP - BR. achenriques@uol.com.br
Zanon
Aline Biral
AB
Godinho
Carlos Alberto
CA
Martins
Lourdes Conceição
LC
Saad Junior
Roberto
R
Speranzini
Manlio Basilio
MB
Waisberg
Jaques
J
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D004937:Esophageal Fistula / Q000453:epidemiology / Q000209:etiology; D004938:Esophageal Neoplasms / Q000601:surgery*; D004940:Esophageal Stenosis / Q000453:epidemiology / Q000209:etiology; D016629:Esophagectomy; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000601:surgery*