title: Outcomes of cervical end-to-side triangulating esophagogastric anastomosis with minimally invasive esophagectomy.
abstract: BACKGROUND
  Esophagogastric anastomosis after esophagectomy has been performed with a variety of techniques during the past decade. However, anastomotic leakage and stricture are still important clinical problems after esophagogastric anastomosis, causing burdensome symptoms and poor quality of life. Herein, we describe a novel cervical end-to-side triangulating esophagogastric anastomoasis using linear stapler.
  
  
  METHODS
  A total of 90 patients (85 % male; mean age 63 years) with thoracic esophageal cancer who underwent cervical end-to-side esophagogastric triangular anastomosis using a linear stapler after minimally invasive esophagectomy between November 2006 and April 2013 were retrospectively reviewed.
  
  
  RESULTS
  The median operation time was 602 min (range 424-936 min). The volume of blood loss during the entire operative procedure was 127 ml (range 0-700 ml). There were no cases of anastomotic leakage in this study, although four patients (4.4 %) developed dysphagia associated with benign anastomotic stricture formation. All patients with a benign anastomotic stricture underwent balloon dilation, which resulted in improvement in their symptoms.
  
  
  CONCLUSIONS
  Considering the absence of anastomotic leakage and low rate of anastomotic stricture formation in this study, our modified triangular esophagogastric anastomosis technique appears promising and may contribute to reduced morbidity and mortality rates following esophagectomy.
authors.affiliation: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Fukuoka, 812-8582, Japan, knakata@surg1.med.kyushu-u.ac.jp.
authors.forename: Kohei
authors.initials: K
authors.lastname: Nakata
authors.forename: Eishi
authors.initials: E
authors.lastname: Nagai
authors.forename: Kenoki
authors.initials: K
authors.lastname: Ohuchida
authors.forename: Katsuya
authors.initials: K
authors.lastname: Nakamura
authors.forename: Masao
authors.initials: M
authors.lastname: Tanaka
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D016063:Blood Loss, Surgical; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D003680:Deglutition Disorders / Q000209:etiology; D004106:Dilatation; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D061646:Operative Time; D012189:Retrospective Studies; D013270:Stomach / Q000601:surgery*; D013528:Surgical Staplers; D016896:Treatment Outcome