Clinical Analysis of Ssophagovisceral Anastomosis

식도 장 문합수술의 임상적 고찰

  • Published : 1995.11.01

Abstract

Thirty patients who underwent esophageal resections due to esophageal carcinoma and benign strictures, and esophagovisceral anastomoses were performed by hand suture in 11 patients[Group I and by using the end to end anastomosis[EEA stapler in 19 patients[Group II . Anastomoses were performed in the thoracic cavity in 24 patients[Right 19, Left 5 and in the cervical area in 6 patients. There was one operative mortality[3.3% in a cancer patient who underwent Ivor-Lewis operation using EEA stapler. She expired on POD 38 days due to renal failure and sepsis. There were two anastomotic leakage in the sutured group and no anastomotic leakage in the stapled group. Late anastomotic strictures occurred in 10 patients[52.6% in the stapled group compared to 2 patients[18.1% in the sutured group. Most of the patients with late anastomotic strictures responded to one or two trials of TTS dilations. Using EEA stapler in performing esophagovisceral anastomosis is a safe method with acceptable range of complication rate, and total admission period after the operation for group I was 30.3 days compared to 25.4 days in group II although it had no clinical significance. The follow up was possible in 23 patients; 5 patients in group I died within mean 12.6 months and 9 patients in group II within mean 14.2 months.

Keywords

References

  1. J Thorac Cardiovasc Surg v.97 Anastomotic narrowing following esophagogastrectomy using the EEA stapling device Muehrcke,D.D.;Kaplan,D.K.;Donnelly,R.J.
  2. Acta Chir Scand v.136 Experience in the application of the instrumental mechanical suture in surgery of the stomach and rectum Androsov,P.J.
  3. Surg Gynecol Obstet v.164 Stapled esophagogastric anastomosis in the apex of the right chest after subtotal esophagectomy for carcinoma Wong,J.
  4. Ann Surg v.198 Three years experience with the esophageal stapling device Behl,P.R.;Holden,M.P.;Brown,A.H.
  5. Ann Chir v.25 Comparison chezl' homme des anastomoses oesophagogastriques a la pince PKS 25 et a la suture Maillard,J.N.;Goyer,B.;Lortat-Jacob, J. L.
  6. Am J Surg v.147 Stapled esophagogastric anastomosis Hopkins,R.A.;Alexander,J.C.;Postlethwait,R.W.
  7. Thorax v.37 Oesophagogastrectomy using the end to end anastomotic stapler Fabri,B.;Donnelly,R.J.
  8. Am J Surg v.136 Stapling technique for esophagogastrostomy after esophagogastric resection Chassin,J.L.
  9. Ann Surg v.188 Use of the stomach as on esophageal substiture Akiyama,H.;Miyazono,H.;Tsurumaru,M.;Hashimoto,C.;Kawamura,T.
  10. Ann Surg v.194 Principles of surgical treatment for carcinoma of the esophagus. Analysis of lymph node involvement Akiyama,H.;Tsurumaru,M.;Kawamura,T.;Ono,Y.
  11. Ann Surg v.195 Carcinoma of the esophagus. Observations of 40 years Parker,E.F.;Gregorie,H.B.;Prioleau,W.H.Jr;Marks,R.D.;Bartles,D.M.
  12. Ann Thorac Surg v.33 Clinical efficacy of the stapled anastomosis in esophageal reconstruction Sugimachi,K.;Ikeda,M.;Ueo,H. (et al.)
  13. Ann Surg v.193 Esophagogastrostomy with the EEA Stapler West,P.N.;Marbarger,J.P.;Martz,M.N.;Roper,C.L.
  14. Sugery v.101 Esophagogastric anastomosis performed with a stapler : The occurrence of leakage and stricture Wong,J.;Chueng,H.;Lui,R, (et al.)
  15. Ann Surg v.205 Esophagogastrectomy for benign esophageal stricture Bender,E.M.;Walbaun,P.R.
  16. J Thorac Cardiovasc Surg v.88 Surgery for benign esophageal stricture Keenan,D.J.M.;Hamilton,J.R.L.;Gibbons,J.;Stevenson,H.M.
  17. Ann Surg v.200 Tranhiatal esophagectomy without thoracotomy for carcinoma of the thoracic esophagus Orringer,M.B.
  18. J Thorac Cardiovasc Surg v.96 Cervical esophagogastric anastomosis for benign disease Orringer,M.B.;Stirling,M.C.
  19. Surg Gynecol Obstet v.152 A comparison of ent-to-end staple and suture colorectal anastomosis in the dog Polglase,A.L.;Hughes,E.S.R.;McDermott,F.T.;Burke,F.R.
  20. Ann Surg v.205 Local recurrence after subtotal esophagogastrectomy for squamous cell carcinoma Tam,P.C.;Cheung,H.C.;Ma,L.;Sui,K.F.;Wong,J.