Although esophagogastric(EG) anastomosis with a circular surgical stapler (EEA or ILS) is a safe and convenient procedure with less anastomotic leakage, an concern for the anastomotic stricture still remains, especially in patients with small
esophagus.
We modified cervical EG anastomotic technique using straight thoracoscopic endostapler ot prevent EG anastomotic stricture. Prospective clinical study was performed to determine the feasibility of our modification using Endo-GIA(US Surgical
Corp.,
Norwalk), during the period from October, 1994 to July, 1995, in thirteen patients with carcinoma of the thoracic esophagus. A stomach tube was reanastomosed to the cervical esophagus utilizing a 30 mm Endo-GIA after esophagectomy and node
dissection.
There was one early mortality due to respiratory failure and pulmonary tuberculosis. Anastomotic leakage with resultant stricture was noticed one patient, and it was related to ischemic necrosis of the stomach tube. The overall incidence of
stricture
was 7.6%(1/13). During the 8 month follow-up period, the remaining 11 patients did not show any clinical evidence of stricture such as dysphagia. All patients were on a regular diet. We conclude that our new technique for cervical EG anastomosis
with
GIA-Endo stapler is a safe and convenient procedure in preventing anastomotic stricture.
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