title: Stability of cervical esophagogastrostomy via hand-sewn anastomosis after esophagectomy for esophageal cancer.
abstract: The aim of the present study is to evaluate the outcome of hand-sewn esophagogastric anastomosis during radical esophagectomy for esophageal cancer. The outcomes of 467 consecutive esophageal cancer patients who underwent cervical esophagogastric anastomosis using interrupted and double-layered sutures after radical esophagectomy via right thoracotomy or thoracoscopic surgery were retrospectively reviewed. Anastomotic leakage, including conduit necrosis, occurred in 11 of 467 patients (2.4%); 7 of 11 (63.6%) cases experienced only minor leakage, whereas the other four (36.4%) patients had major leakage that required surgical or radiologic intervention, including two patients of conduit necrosis. Anastomotic leakages were more frequently observed after retrosternal reconstruction compared with the posterior mediastinal route (P < 0.0001). The median time to healing of leakage was 40 days (range: 14-97 days). Two patients (2/467, 0.4%) died in the hospital due to sepsis caused by the leakage and conduit necrosis. Twelve patients (2.6%) developed anastomotic stenosis, which was improved by dilatation in all patients. Hand-sewn cervical esophagogastric anastomosis is a stable and highly safe method of radical esophagectomy for esophageal cancer.
authors.affiliation: Department of Surgery.
authors.forename: Y
authors.initials: Y
authors.lastname: Akiyama
authors.affiliation: Department of Surgery.
authors.forename: T
authors.initials: T
authors.lastname: Iwaya
authors.affiliation: Department of Surgery.
authors.forename: F
authors.initials: F
authors.lastname: Endo
authors.affiliation: Department of Surgery.
authors.forename: Y
authors.initials: Y
authors.lastname: Shioi
authors.affiliation: Department of Surgery.
authors.forename: T
authors.initials: T
authors.lastname: Chiba
authors.affiliation: Department of Surgery.
authors.forename: T
authors.initials: T
authors.lastname: Takahara
authors.affiliation: Department of Surgery.
authors.forename: K
authors.initials: K
authors.lastname: Otsuka
authors.affiliation: Department of Surgery.
authors.forename: H
authors.initials: H
authors.lastname: Nitta
authors.affiliation: Department of Surgery.
authors.forename: K
authors.initials: K
authors.lastname: Koeda
authors.affiliation: Department of Surgery.
authors.forename: M
authors.initials: M
authors.lastname: Mizuno
authors.affiliation: Department of Palliative Medicine, Iwate Medical University School of Medicine, Iwate, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kimura
authors.affiliation: Department of Surgery.
authors.forename: A
authors.initials: A
authors.lastname: Sasaki
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D057868:Anastomotic Leak / Q000453:epidemiology* / Q000209:etiology; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D004946:Esophagostomy / Q000009:adverse effects / Q000379:methods*; D004947:Esophagus / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: esophageal cancer; esophagectomy; hand-sewn anastomosis