| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1998;65:814-817
© 1998 The Society of Thoracic Surgeons
Department of Surgery, Louvain Medical School, Brussels, Belgium
Department of Radiology, Louvain Medical School, Brussels, Belgium
Accepted for publication September 23, 1997.
Dr Collard, Digestive Surgery Unit, Saint-Luc Academic Hospital, Hippocrate Ave, 10, B-1200 Brussels, Belgium.
Background. The classic manual end-to-side technique of esophagogastrostomy after gastric pull-up to the neck carries a rather high risk of fistula and stricture.
Methods. A terminalized semimechanical side-to-side technique of cervical esophagogastrostomy was performed in 16 patients by the application of an Endo-GIA stapler across the gastric and esophageal walls placed side by side, so as to create a V-shaped posterior opening between the two lumina. The anterior aspect of the anastomosis was hand-sewn using a classic running suture. The cross-sectional area of the semimechanical anastomoses was estimated by barium swallow study 2 months after operation and compared with that of 24 manual end-to-side esophagogastrostomies.
Results. The cross-sectional area was 225 ± 15.7 mm2 (mean ± standard error of the mean) for the 16 semimechanical anastomoses versus 136 ± 15 mm2 for the 24 manual anastomoses (p = 0.0001). The anastomotic area decreased from 206.6 ± 13.5 mm2 in 29 patients without dysphagia to 107.5 ± 4.7 mm2 in 7 patients with moderate dysphagia for solids that did not require endoscopic dilation and to 55.7 ± 16 mm2 in 4 patients with severe dysphagia that required dilation (p = 0). The anastomotic area in 6 of the 7 patients with initial moderate dysphagia for solids increased spontaneously with time from 107.3 ± 5.5 mm2 to 174.6 ± 8.1 mm2, with concomitant symptomatic relief (p = 0.0277).
Conclusions. The terminalized semimechanical side-to-side suture technique produces a larger anastomosis than the classic end-to-side esophagogastrostomy technique. Inflammatory changes related to the operation may cause transient narrowing of a cervical esophagogastrostomy.
This article has been cited by other articles:
|
|
 |
|
  S. H. Blackmon, A. M. Correa, B. Wynn, W. L. Hofstetter, L. W. Martin, R. J. Mehran, D. C. Rice, S. G. Swisher, G. L. Walsh, J. A. Roth, et al. Propensity-Matched Analysis of Three Techniques for Intrathoracic Esophagogastric Anastomosis Ann. Thorac. Surg., May 1, 2007; 83(5): 1805 - 1813. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Chunwei, N. Qingzeng, L. Jianliang, and W. Weiji Cervical esophagogastric anastomosis with a new stapler in the surgery of esophageal carcinoma Eur. J. Cardiothorac. Surg., August 1, 2005; 28(2): 291 - 295. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Ercan, T. W. Rice, S. C. Murthy, L. A. Rybicki, and E. H. Blackstone Does esophagogastric anastomotic technique influence the outcome of patients with esophageal cancer? J. Thorac. Cardiovasc. Surg., March 1, 2005; 129(3): 623 - 631. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. De Giacomo, F. Francioni, F. Venuta, P. Trentino, M. Moretti, E. A. Rendina, and G. F. Coloni Complete mechanical cervical anastomosis using a narrow gastric tube after esophagectomy for cancer Eur. J. Cardiothorac. Surg., November 1, 2004; 26(5): 881 - 884. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. B. Orringer, B. Marshall, and M. D. Iannettoni ELIMINATING THE CERVICAL ESOPHAGOGASTRIC ANASTOMOTIC LEAK WITH A SIDE-TO-SIDE STAPLED ANASTOMOSIS J. Thorac. Cardiovasc. Surg., February 1, 2000; 119(2): 277 - 288. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
