PMID: 9164519Mar 1, 1997Paper

Mechanically stapled esophagojejunostomy. Results of a prospective series of 176 cases

Hepato-gastroenterology
B PolJ R Delpero

Abstract

To evaluate the reliability of stapled esophagojejunostomy. We studied a non-selected prospective series of 176 consecutive total gastrectomies (169 cancers, 7 benign pathologies). Hand-sewn esophagojejunostomy was performed 5 times after failure of the stapled esophagojejunostomy. There were fourteen hospital deaths (8%), and 63 patients (36%) presented complications. There were 5 anastomotic leaks (2.8%) but non were responsible for deaths. In these 5 cases, there had been an incident during construction of the esophagojejunostomy. Such an incident was the only significant risk factor for an anastomotic leak: 17% after an incident and 0% in the absence of an incident (p < 0.001). We observed no cases of anastomotic stricture. Stapled esophagojejunostomy is a reliable technique when technical precautions are taken. It is easier to reproduce than hand-sewn esophagojejunostomy and has demonstrated low specific morbidity and no direct mortality.

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