Online ISSN: 2515-8260

Experience with a Novel Technique of Stapled side side cervical esophagogastric anastomosis using two linear cutting staplers in Ca Oesophagus

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Tarun Kumar Batra1 , Manjot Kaur 2 , Mandar Tilak3

Abstract

Background: Anastomotic leak from cervical esophagogastric anastomoses is a serious problem after esophagectomy. Various modifications of anastomotic techniques have evolved to minimize anastomotic complications. This study presents the technique of cervical esophagogastric anastomosis using linear cutting staplers and experience with the technique compared to the hand-sewn anastomosis. Materials and Methods:105 patients with oesophagus or gastroesophageal junction carcinoma underwent curative-intent resection either via a right posterolateral thoracotomy (TTE) or transhiatal esophagectomy or video-assisted thoracoscopic surgery. 57 patients with treated with linear stapler technique (Group A) and 48 patients were treated with handsewn anastomosis(Group B).The average follow-up was approximately 18 months. Results:Anastomotic leakage was observed in one patient(1.75%) in linear anastomosis technique and thirteen patients (27.7%) inhand-sewn technique. There was no incidence of anastomotic site stricture in group A. In contrast, three patients (6.25%) had post anastomotic stricture in group B. Early postoperative morbidity in the form of respiratory infections was seen in 15 patients in linear stapler group as compared to 8 patients in the hand-sewn group. Conclusion: The linear-stapled esophagogastric anastomosis is a safe and effective anastomotic technique, which can decrease the rate of leak, postoperative dysphagia, and anastomotic stricture. This technique uses only 2 linear staplers whereas other techniques use three or more staplers which are also cost-effective. The procedure deserves more attention and further application.

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