Side-to-side stapled intra-thoracic esophagogastric anastomosis reduces the incidence of leaks and stenosis

Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus
D J RazMarco G Patti

Abstract

Trans-hiatal esophagectomy with a hand-sewn anastomosis was for 2 decades the preferred approach in our institution for patients with esophageal cancer. In our experience, this anastomotic technique was associated with a 12% leak rate and a 48% rate of stricture requiring dilatation. We sought to determine if a side-to-side intra-thoracic anastomosis was associated with a lower rate of anastomotic stricture and leak. Thirty-three consecutive patients with distal esophageal cancer or Barrett's esophagus with high grade dysplasia underwent a trans-thoracic esophagectomy with a side-to-side stapled intra-thoracic anastomosis. The overall morbidity was 27%, with no anastomotic stricture or leaks. One patient died (3%). The median time to the resumption of an oral diet was 7 days (range 5-28), and the median length of stay in hospital was 9 days (range 6-45). Trans-thoracic esophagectomy with a side-to-side stapled anastomosis is safe and it is associated with a very low rate of anastomotic complications. We consider this to be the procedure of choice for patients with distal esophageal cancers.

References

Dec 1, 1991·American Journal of Surgery·M G PattiC A Pellegrini
Mar 1, 1993·The British Journal of Surgery·M GoldmincB Launois
Jun 1, 1996·The Journal of Thoracic and Cardiovascular Surgery·P HonkoopM van Blankenstein
Dec 3, 1998·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·M G PattiL W Way
Jan 29, 2000·The Journal of Thoracic and Cardiovascular Surgery·M B OrringerM D Iannettoni
Mar 16, 2000·The British Journal of Surgery·K AkhtarR J Watson
Dec 11, 2002·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·A G CassonP J Veugelers
Dec 3, 2003·The New England Journal of Medicine·John D BirkmeyerF Lee Lucas
Mar 5, 2005·The Journal of Thoracic and Cardiovascular Surgery·Sina ErcanEugene H Blackstone
Nov 22, 2005·Journal of Surgical Oncology·Alan G Casson, J Jan B van Lanschot
Feb 28, 2006·Journal of the American College of Surgeons·Huibert A CenseJ Jan B van Lanschot
Mar 1, 2006·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Lily C ChangCarlos A Pellegrini

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Citations

Aug 26, 2014·Journal of Surgical Oncology·Subroto Paul, Nasser Altorki
Oct 14, 2008·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Cassandra E Kight
Oct 3, 2014·The Cochrane Database of Systematic Reviews·Yong YuanYongfan Zhao
Feb 5, 2009·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·Judith BooneRichard van Hillegersberg
Aug 7, 2012·Surgery Today·Ming-Ho Wu, Hsing-Hsien Wu
Jul 10, 2013·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Marco E AllaixMarco G Patti
Jan 21, 2014·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·Y YuanL-Q Chen
Oct 29, 2014·Annals of the Royal College of Surgeons of England·J McK Manson, W D Beasley
Apr 13, 2011·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Qi-Rong XuLong-Qi Chen
Aug 23, 2012·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Hiroshi OkabeYoshiharu Sakai
Dec 5, 2012·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·C BehrenbruchR Cade
Dec 5, 2019·World Journal of Gastrointestinal Surgery·Robert TylerJan Dmitrewski

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