title: Modified triangulating stapling technique for esophagogastrostomy after esophagectomy for esophageal cancer.
abstract: BACKGROUND
  Anastomosis performed during esophagectomy for esophageal cancer is usually involves hand-sewn or circular stapled methods. However, these techniques have been reported to be associated with a high frequency of anastomotic complications, including leakage and benign stenosis. Here a novel triangulating stapling technique for esophagogastrostomy after esophagectomy for esophageal cancer and its retrospective investigation are described.
  
  
  METHODS
  Forty-eight patients were underwent esophagectomy for esophageal cancer from January 2006 to December 2009 by the same surgeon using the triangulating stapling technique. The short-term outcomes were evaluated retrospectively. This end-to-end anastomosis used three linear staplers in an everted fashion.
  
  
  RESULTS
  Patients comprised 36 men and 12 women with a mean age of 59.4 years. Anastomotic leakage occurred in 4 patients (8.3 %), while anastomotic stenosis was observed in 6 (12.5 %). The average number of endoscopic pneumatic dilatations in patients with anastomotic stenosis was 2.4. The median (range) duration of hospital stay was 40.8 (19-154) days.
  
  
  CONCLUSIONS
  Our modified triangulating stapling technique for esophagogastrostomy may be a feasible alternative, resulting in a lower frequency of postoperative anastomotic complications.
authors.affiliation: Department of Upper Gastrointestinal Surgery, Hyogo College of Medicine, 1-1, Mucogawa-machi, Nishinomiya, Hyogo, 663-8501, Japan. mtake@hyo-med.ac.jp
authors.forename: Masashi
authors.initials: M
authors.lastname: Takemura
authors.forename: Kayo
authors.initials: K
authors.lastname: Yoshida
authors.forename: Yushi
authors.initials: Y
authors.lastname: Fujiwara
mesh_terms: D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D004946:Esophagostomy / Q000379:methods*; D005260:Female; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017792:Surgical Stapling / Q000379:methods