Modified application of circular stapler to cervical esophagogastric anastomosis after esophagectomy for esophageal cancer

Abstract

Background and Objective: Anastomotic leakage and fibrous stenosis are significant complications of the cervical esophagogastric anastomosis although cervical esophagogastric anastomosis appears to decrease morbidity as compared with intrathoracic anastomosis. We modified the techniques of cervical esophagogastric anastomosis using circular stapler after resection of esophageal carcinoma, and evaluated its efficacy. Methods: Between October 2006 and April 2008, 127 patients underwent esophagectomy using gastric tissues positioned in the original esophageal bed as esophageal substitute for reconstruction. Cervical esophagogastric anastomosis using circular stapler was performed in all patients. The occurrence of postoperative complications was recorded and analyzed. Results: No operation-related death and no anastomotic hemorrhage occurred. Anastomotic leakage developed in one patient (0.8%) because of instrumental failure; five patients (3.9%) developed fibrous stenosis that required stricture dilation. Conclusion: Modified mechanical cervical esophagogastric anastomosis using circular stapler is effective and safe, and can reduce the occurrence of postoperative anastomotic complications.