Esophagectomy and cervical side-to-side stapled esophagogastric anastomosis.

Objective: To determine the clinical effect and the prospect of cervical side-to-side stapled esophagogastric anastomosis.

Methods: Eighteen cases of upper and middle thoracic esophageal carcinoma were treated with esophagectomy and cervical side-to-side stapled esophagogastric anastomosis. The clinical data were collected and retrospectively analyzed. The average age of patients was 60.7 years and the ratio of male to female was 17:1. The tumor included 4 upper part and 14 middle thoracic parts. The length of tumors was from 1 cm to 7 cm, with an average of 3.2 cm.

Results: The post-operative TNM staging(AJCC) included 4 Stage IIa,9 Stage IIb,and 5 Stage III. The operative incisions included 8 nontransthoracic cervical and abdominal double incisions, 9 right cervico-thoraco-abdominal triple incisions, and 1 left cervico-thoracic incision. One (5.56%) patient complicated with anastomotic leakage and was cured in 2 weeks by cervical drainage and absolute diet. All the 18 patients were followed up for 1 to 5 years,and no anastomotic stricture was found. Reflux esophagitis was found in 2 and the incidence rate was 11.11%.

Conclusions: Cervical side-to-side esophagogastric anastomosis is a safe procedure with larger resection of margins and fewer complications. It is worth replicating.