Mechanical Esophageal Anastomosis: Retrospective Study of 56 Patients

MECHANICAL ESOPHAGEAL ANASTOMOSIS: RETROSPECTIVE STUDY OF 56 PATIENTS (Abstract): Aim: To analyze outcomes of intrathoracic esophageal anastomosis performed using mechanical stapling devices . Methodology: We retrospectively analyzed the records of 56 consecutive patients who underwent esophagectomy, total gastrectomy, or degastro-gastrectomy with mechanical intrathoracic esophageal anastomosis between 1995 and 2006. The mean age of patients according to procedure were 62.5, 67.4, and 69.6 years, respectively. Results: We observed only one anastomotic leak (1.6%), which we treated medically. Postoperative mortality was 12.5%; no deaths were related to the presence of an anastomotic leak or to surgical complications. Four of the 45 satisfactorily-followed patients (8.8%) presented with anastomotic stenosis; all patients were treated successfully by endoscopic dilatation. Conclusion: Intra-thoracic esophageal anastomoses can be performed more efficiently using mechanical stapling devices. The risk of stenosis is reduced when the anastomoses are termino-lateral and when their diameter is as wide as possible. Strictures can be treated efficiently by endoscopic dilatation.