Jiang H.,Tianjin Medical University |
Jiang H.,State Key Laboratory for Cancer Treatment and Prevention |
Yu Z.,Tianjin Medical University |
Yu Z.,State Key Laboratory for Cancer Treatment and Prevention |
And 6 more authors.
Chinese Journal of Clinical Oncology
Objective: To study the advantages of total mechanical stapled intrathoracic esophagogastric anastomosis during esophagectomy. Methods: Total mechanical stapled intrathoracic side-to-side esophagogastric anastomosis was performed in 18 patients that underwent Ivor-Lewis esophagectomy from January 2009 to February 2011. The procedure was done using a linear cutting and stitching instrument to conduct a lengthwise suture of the posterior wall of the esophagogastric anastomotic stoma to extend the posterior wall of the esophagogastric anastomotic stoma by at least 3 cm. Then, the stitching instrument was also used to close the anterior wall of the stoma. Follow up was conducted on all patients. Gastrofiberscopy and barium swallow contrast examination were conducted to assess the inner diameter of the stoma. Results: Total mechanical stapled intrathoracic side-to-side anastomoses were smoothly performed in 17 of the 18 cases. No postoperative fistula and remnants of the surgical margin were found in these cases. All the cases were followed up for 3 to 24 months. Food intake was easy and smooth for the patients. Gastrofiberscopy was conducted in seven of the cases, and contrast examination was conducted in 15 cases. Slight stenosis of the anastomotic stoma was found in only one patient, and endoscopic dilation was not used. The area of the stoma was (2.23 ± 0.35) cm2. Conclusion: Total mechanical stapled intrathoracic esophagogastric anastomosis during esophagectomy is safe. It can effectively reduce the postoperative stricture rate and the need for dilation. Considering the lack of a randomized control study, whether the method can substitute for traditional anastomosis using a tubulation stapler remains unclear. Further studies are therefore needed. Source