Mechanically stapled esophagojejunostomy. Results of a prospective series of 176 cases
Pol, B.; LeTreut, Y.P.; Hardwigsen, J.; Rosset, E.; Houvenaeghel, G.; Delpero, J.R.
Hepato-Gastroenterology 44(14): 458-466
1997
ISSN/ISBN: 0172-6390 PMID: 9164519 Document Number: 479741
Background/Aims: To evaluate the reliability of stapled esophagojejunostomy. Material and Methods: We studied a non-selected prospective series of 176 consecutive total gastrectomies (169 cancers, 7 benign pathologies). Results: 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 lt 0.001). We observed no cases of anastomotic stricture. Conclusion: 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.