HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content

Ann Thorac Surg 1997;64:1609-1610
© 1997 The Society of Thoracic Surgeons

---

Discussion

Discussion

The first 20% of the full text of this article appears below.

See also page 1606.

DR WILLIAM W. TAYLOR (Dallas, TX): I presume in most of these patients where you did an esophagectomy you only took out the lower third of the esophagus and not the entire esophagus. Is that correct?

Then, if you took out just the lower esophagus and brought the stomach up, do you favor hand-sewn or the end-to-end anastomosis, and could you comment on those aspects of it for us?

DR VLESSIS: Of the patients who had resection of their esophagus, only 2 had intrathoracic gastroesophageal anastomoses; the rest of the patients had their anastomoses performed in the neck. The reason for doing this is that the consequences of an anastomotic breakdown in the thoracic cavity are much more extensive than an anastomotic breakdown in the neck. A neck leak can simply be treated by opening the neck incision. An intrathoracic leak is devastating, requires reoperation, and carries a high mortality.

To summarize, only 2 of the 15 patients had intrathoracic anastomosis. The type of anastomosis we do varies somewhat depending on the surgeon, but all the anastomoses were hand sewn with absorbable suture.

DR RODNEY J. LANDRENEAU (Pittsburgh, PA): . . . [Full Text of this Article]