594 HAND-SEWN CERVICAL ESOPHAGOGASTRIC ANASTOMOSIS AFTER ESOPHAGECTOMY. (17th September 2021)

• Record Type: Journal Article
• Authors: Nozaki, Isao; Hato, Shinji; Mikuriya, Yoshihiro; Ochiai, Ryoji; Kobayashi, Naruyuki; Kobatake, Takaya; Ohta, Koji
• Is Part Of: Diseases of the esophagus. Volume 34(2021)Supplement 1
• Publication Date: 2021-09-17
• Subjects: Esophagus -- Diseases -- Periodicals; 616.32
• DOI: 10.1093/dote/doab052.594
• Languages: English
• ISSNs: 1120-8694

Abstract

Abstract: : Successful anastomosis is essential in esophagogastrectomy. Staplers are more popularly applied for the anastomosis. However, a hand-sewn anastomosis is a basic and cost-effective method. Herein, we introduce our technical tips of all hand-sewn cervical esophagogastric anastomosis. Methods: Step 1: A 6 cm gastric tube is created and pulled up through the posterior mediastinal route. Step 2: A single layer Gambee sutures are used to approximate the cervical esophagus and the posterior wall of the gastric tube in end-to-side fashion. Step 3: The redundant part in the gastric tube apex is removed. Results: We analyzed 199 consecutive patients who underwent this anastomosis in our institute from 2004 to 2019. There was no postoperative mortality. Anastomotic leak (Clavien-Dindo classification; Grade ≥ II) rate was 2.5%. Anastomotic stricture which required balloon dilation was 3.5%. Conclusion: The anastomotic complication rates in the hand-sewn anastomosis were comparable to those of the mechanical stapled anastomosis in the previous reports. Video: https://www.dropbox.com/s/sxnxs4962aj5n5k/anastomosis.mp4?dl=0 .