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  • Title: Mechanically stapled esophagojejunostomy. Results of a prospective series of 176 cases.
    Author: Pol B, LeTreut YP, Hardwigsen J, Rosset E, Houvenaeghel G, Delpero JR.
    Journal: Hepatogastroenterology; 1997; 44(14):458-66. PubMed ID: 9164519.
    Abstract:
    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.
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