[Comparative analysis of mechanical and manual cervical esophagogastric anastomosis following esophagectomy for esophageal cancer].
OBJECTIVE
To compare the complications associated with mechanical and manual cervical esophagogastric anastomosis following esophagectomy for esophageal cancer.


METHODS
From September, 2004 to June, 2007, 227 patients with middle and upper thoracic esophageal cancer underwent cervical esophagogastric anastomosis after esophagectomy. The patients were randomized into two groups and cervical esophagogastric anastomosis was performed using a stapler (n=102) or manually (n=125). The incidence of postoperative complications and operative time were compared between the two groups.


RESULTS
In manual anastomosis group, anastomotic leak and anastomotic stricture occurred in 14.4% (18/125) and 8.8.% (11/125) of the patients, significantly higher than the incidences of 2.9% (3/102) and 3.9% (4/102) in the mechanical anastomosis group (P<0.01). Manual anastomosis required a significantly longer operative time than mechanical anastomosis (52∓12 vs 25∓5 min, P<0.01).


CONCLUSIONS
The use of circular mechanical stapler in cervical esophagogastric anastomosis is associated with a lower rate of anastomotic leak and a shorter operative time, and is easy to learn and standardize to reduce the complications of the anastomosis.
Department of Thoracic Surgery, Southern Medical University, Guangzhou, China. cairjundr@163.com
Ruijun
R
Cayi
Mei
M
Li
Gang
G
Xiong
Kaican
K
Cai
Wujun
W
Wang
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D057868:Anastomotic Leak; D003251:Constriction, Pathologic; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013537:Sutures; D016896:Treatment Outcome