Cervical esophagogastric anastomosis with invagination after esophagectomy.
OBJECTIVE
To evaluate the incidence of fistula and stenosis of the cervical esophagogastric anastomosis with invagination of the proximal esophageal stump into the stomach after subtotal esophagectomy.


METHODS
We studied 54 patients who underwent subtotal esophagectomy, 45 (83.3%) patients with carcinoma and nine (16.6%) with advanced megaesophagus. In all cases the cervical esophagogastric anastomosis was performed with the invagination of the proximal esophageal stump inside the stomach.


RESULTS
Three (5.5%) patients had a fistula at the esophagogastric anastomosis, two of whom with minimal leakage of air or saliva and with mild clinical repercussion; the third had a low output fistula that drained into the pleural space, and this patient developed empyema that showed good progress with drainage. Fibrotic stenosis of anastomosis occurred in thirteen (24%) subjects and was treated successfully with endoscopic dilatation.


CONCLUSIONS
Cervical esophagogastric anastomosis with invagination of the proximal esophageal stump into the stomach tube presented a low rate of esophagogastric fistula and stenosis, thus becoming an attractive option for the reconstruction of alimentary transit after subtotal esophagectomy.
Department of Surgery, FMABC, Sao Bernardo-SP, Brazil. achenriques@uol.com.br
Alexandre Cruz
AC
Henriques
Felipe Emanuel
FE
Fuhro
Carlos Alberto
CA
Godinho
Andre Luiz Lopes Cardoso
AL
Campos
Jaques
J
Waisberg
D000368:Aged; D000714:Anastomosis, Surgical; D002277:Carcinoma / Q000601:surgery*; D004931:Esophageal Achalasia / Q000601:surgery*; D004937:Esophageal Fistula / Q000209:etiology*; D004938:Esophageal Neoplasms / Q000601:surgery*; D004940:Esophageal Stenosis / Q000209:etiology*; D016629:Esophagectomy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D013270:Stomach / Q000601:surgery