Mechanically stapled esophagojejunostomy. Results of a prospective series of 176 cases.

Background/aims: To evaluate the reliability of stapled esophagojejunostomy.

Material And Methods: We studied a non-selected prospective series of 176 consecutive total gastrectomies (169 cancers, 7 benign pathologies).

Results: Hand-sewn esophagojejunostomy was performed 5 times after failure of the stapled esophagojejunostomy. There were fourteen hospital deaths (8%), and 63 patients (36%) presented complications. There were 5 anastomotic leaks (2.8%) but non were responsible for deaths. In these 5 cases, there had been an incident during construction of the esophagojejunostomy. Such an incident was the only significant risk factor for an anastomotic leak: 17% after an incident and 0% in the absence of an incident (p < 0.001). We observed no cases of anastomotic stricture.

Conclusion: Stapled esophagojejunostomy is a reliable technique when technical precautions are taken. It is easier to reproduce than hand-sewn esophagojejunostomy and has demonstrated low specific morbidity and no direct mortality.