Impact of fundus rotation gastroplasty on anastomotic complications after cervical and thoracic oesophagogastrostomies: A prospective non-randomised study

Abstract

Objective: To find out the leak rate after cervical or thoracic anastomoses of oesophagus to fundus rotation gastric tubes after oesophagectomy. Design: Prospective non-randomised study. Setting: University hospital. Switzerland. Subjects: 95 patients, of whom 62 had cervical and 33 thoracic anastomoses. Interventions: Anastomoses were hand sewn in two layers between oesophagus and a gastric tube, that was elongated by 30% by a stapled fundus rotation gastroplasty. Anastomotic patency was studied clinically and radiographically between the 5th and 7th postoperative days. Results: Five of the 62 patients had a clinical or radiological anastomotic leak (8%) in the neck and 2 of the 33 patients in the thorax (6%). Six patients died, one death being the result of a leak. Conclusion: Length and blood supply of fundus rotation gastroplasty tubes allows for safe anastomoses at thoracic and cervical levels.