Submitted: 19 Oct 2012
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J Cardiovasc Thorac Res. 2013;5(1): 11-16.
doi: 10.5681/jcvtr.2013.003
PMID: 24251003
PMCID: PMC3825376
  Abstract View: 571
  PDF Download: 423

Original Article

The Role of Esophagogastric Anastomotic Technique in Decreasing Benign Stricture Formation in the Surgery of Esophageal Carcinoma

Mohsen Sokouti 1, Samad EJ Golzari 2,3 * , Masoud Pezeshkian 1, Mohammad-Reza Farahnak 4

1 Department of Cardiothoracic Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
2 Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
3 Students’ Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
4 Department of Surgery, 22-Bahman Hospital, Masjedsoleiman, Iran


Introduction: Postoperative stenosis and dysphagia after esophageal carcinoma resection is the major problem. The aim of this study is to compare two types cervical esophagogastric anastomosis in reduction of stricture formation in esophageal cancer surgery. Methods: The subjects of this study were 223 patients undergoing esophageal carcinoma resection during 1998 to 2007. Twenty two patients were excluded from the study because of recurrent malignancy of anastomosis, mortality and losing in follow up period. Two hundred and one patients remained by the end of study were classified into two groups: 98 patients were treated by routinely transverse hand-sewn cervical esophagogastric anastomosis (group 1); and 103 patients were treated by the proposed oblique hand-sewn esophagogastric anastomotic technique (group 2). All the operations were with high abdominal and left cervical incisions (Transhiatal esophagectomy). All patients of both groups were followed up at least 6-month for detection of anastomotic strictures. Results: Postoperative dysphagia occurred in 20 patients of group 1 versus 5 patients of group 2. In working up by rigid esophagoscopy, two patients of group 2 and four patients of group 1 had not true strictures. Anastomotic strictures occurred in 16 cases of group 1, versus 3 cases of group 2. Statistical comparative analysis results of two groups about stricture formation were significant (3% versus 16% P= 0.003). Conclusion: The oblique hand-sewn esophagogastric anastomostic techniques reduce markedly the rate of stricture formation after esophagectomy.
Keywords: Esophagus, Carcinoma, Esophagectomy, Anastomotic Stricture
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