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Ann Thorac Surg 1994;58:1087-1089
© 1994 The Society of Thoracic Surgeons

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Articles

Single-layered cervical esophageal anastomoses: A prospective study of two suturing techniques

First Department of Surgery, University of Padua Medical School, Padova, Italy

Accepted for publication February 24, 1994.

^_* Address reprint requests to Dr Bardini, Clinica Chirurgica I, Via Giustiniani 2, 35128 Padova, Italy.

We carried out a prospective, randomized study over a 1-year period to compare the efficacy of a single layer of continuous absorbable monofilament (Maxon) with that of a single layer of interrupted Polyglactin sutures (Vicryl) in the performance of cervical esophagogastric anastomoses. Forty-two consecutive patients with carcinoma of the esophagus or cardia, in whom the stomach was transposed through the mediastinal route after esophagectomy, were enrolled in the study. There were 21 patients in each group. There was no hospital mortality. One asymptomatic anastomotic leak and two early anastomotic strictures requiring dilation occurred in patients in whom an interrupted technique was employed. The continuous technique required significantly less operative time (p < 0.0001), and the cost of the suture material was reduced markedly. We conclude that either a continuous or an interrupted monolayer esophagogastric anastomosis can give satisfactory results after esophagectomy for cancer, provided that the vascular supply to the gastric fundus is maintained adequately. The continuous technique has the advantages of being time-saving, cheaper, and easier to perform and to teach.

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