Endoscopic Therapy for Symptomatic Benign an astomotic Stenosis After Two Stage Oesophagectomy – Comparasion Between Two an astomotic Techniques

P C Munipalle, Y K S Viswanath, P A Davis

South Tees Hospitals NHS Foundation Trust

Introduction
Oesophago-gastric anastomosis with gastric transposition is a common method of reconstruction following 2 stage oesophagectomy (TSO) for oesophageal cancer but the choice of anastomotic technique is often debatable. We have performed a prospective non randomised study comparing the two methods of anastomosis in vogue, namely hand sewn single layer technique vs. mechanical stapling with circular EEA device.

Methods
All the patients undergoing oesophago-gastric anastomoses over the a 3 year period following curative resection for oesophageal cancer are followed up prospectively; both the hand sewn group and stapler group are compared in terms of symptomatic anastomotic stricture requiring dilatation/ stenting and anastomotic leak.

Results
A total of 77 patients underwent oesophago-gastric anastomoses during this period (Hand sewn anastomosis in 37; Circular EEA anastomosis in 40). In each group the number of anastomotic strictures requiring dilatations were 3:5 (p >0.05); stenting procedures were 1:2 (p >0.05) and there were no anastomotic leakages in any group.

Conclusion
There are no significant differences in the anastomotic stricture rate and anastomotic leakage between the hand-sewn group and the stapler group following TSO. Meticulous technique contributes to the success of anastomosis more than choice of technique.


Session: Poster Presentation

Program Number: P213

« Return to SAGES 2013 abstract archive