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01-05-2013 | How I do it
The Hybrid Intrathoracic Oesophago-gastric Anastomosis in Oesophageal Cancer—Morbidity and Mortality
The Hybrid Intrathoracic Oesophagogastric Anastomosis
Published in: Journal of Gastrointestinal Surgery | Issue 5/2013
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Background
The technique of the side-to-side, hybrid stapled/hand-sewn, intrathoracic, oesophago-gastric anastomosis was first described in 1996 (Bird et al. Aust N.Z J Surg 66:77–763, 1996). However despite some clinical and theoretical advantages, it has never been as popular as either hand-sewn or circular-stapled anastomosis. The aim of this study was to review the experience of a single surgeon (RC) who has used this type of anastomosis since 1993 as the routine means of reconstruction following oesophagectomy.
Methods
A retrospective review of prospectively collected data was performed. The study included 195 consecutive oesophageal resections performed by a single surgeon (RC) from 1993 to 2011.
Results
Of 195 patients undergoing oesophagectomy, 180 patients had an intrathoracic anastomosis for oesophageal cancer. Of the 180 patients, 177 had an anastomosis formed using the hybrid technique. The clinical anastomotic leak rate in this group was found to the 2.7 % with an in hospital mortality of 0.5 %. The total number of patients requiring post-operative dilatation was 17/180 or approximately 9 % of patients.
Conclusions
The hybrid oesophageal anastomosis is associated with a low mortality and anastomotic leak rate and a modest incidence of stricturing.