Esophageal Cancer
Copyright ©The Author(s) 2003. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 15, 2003; 9(1): 22-25
Published online Jan 15, 2003. doi: 10.3748/wjg.v9.i1.22
A new three-layer-funnel-shaped esophagogastric anastomosis for surgical treatment of esophageal carcinoma
Han-Lei Dan, Yang Bai, Hui Meng, Cong-Lin Song, Jie Zhang, Yong Zhang, Lei-Chi Wan, Ya-Li Zhang, Zhen-Shu Zhang, Dian-Yuan Zhou
Han-Lei Dan, Yang Bai, Ya-Li Zhang, Zhen-Shu Zhang, Dian-Yuan Zhou, Research Institute of Digestive Disease, South Hospital, First Military Medical University, Guangzhou 510515, Guangdong Province, China
Hui Meng, Department of Cardio-Thoracic Surgery, South Hospital, First Military Medical University, Guangzhou 510515, Guangdong Province, China
Cong-Lin Song, Jie Zhang, Department of Surgery, No. 520 Hospital, Mianyang 621000, Sichuan Province, China
Yong Zhang, Yanting Oncology Research Institute, Yanting 621042, Sichuan Province, China
Lei-Chi Wan, Department of Cardio-Thoracic Surgery, Pearl River Hospital, Guangzhou 510282, Guangdong Province, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Han-Lei Dan, MD, Doctor-in-chief of Surgery Department. Prf. Ya-Li Zhang, MD, PhD, Research Institute of Digestive Disease, South Hospital (Nanfang Hospital), First Military Medical University, Guangzhou 510515, Guangdong Province, China. henrydan@sina.com
Telephone: +86-20-85141531 Fax: +86-20-85141531
Received: May 14, 2002
Revised: May 23, 2002
Accepted: June 16, 2002
Published online: January 15, 2003
Abstract

AIM: To reduce the incidence of postoperative anastomotic leak, stenosis, gastroesophageal reflux (GER) for patients with esophageal carcinoma, and to evaluate the conventional method of esophagectomy and esophagogastroplasty modified by a new three-layer-funnel-shaped (TLF) esophagogastric anastomotic suturing technique.

METHODS: From January 1997 to October 1999, patients with clinical stage I and II (IIa and IIb) esophageal carcinoma, which met the enrollment criteria, were surgically treated by the new method (Group A) and by conventional operation (Group B). All the patients were followed at least for 6 months. Postoperative outcomes and complications were recorded and compared with the conventional method in the same hospitals and with that reported previously by McLarty et al[7] in 1997 (Group C).

RESULTS: 58 cases with stage I and II (IIa and IIb) esophageal carcinoma, including 38 males and 20 females aged from 34 to 78 (mean age: 57), were surgically treated by the TLF anastomosis and 64 by conventional method in our hospitals from January 1997 to October 1999. The quality of swallowing was improved significantly (Wilcoxon W = 2142, P = 0.0001) 2 to 3 months after the new operation in Group A. Only one patient had a blind anastomatic fistula diagnosed by barium swallow test 2 months but healed up 3 weeks later. Postoperative complications occurred in 25 (43%) patients, anastomotic stenosis in 8 (14%), and GER in 13 (22%). The incidences of postoperative anastomotic leak, stenosis and GER were significantly decreased by the TLF anastomosis method compared with that of conventional methods (χ2 = 6.566, P = 0.038; χ2 = 10.214, P = 0.006; χ2 = 21.265, P = 0.000).

CONCLUSION: The new three-layer-funnel-shaped esophagogastric anastomosis (TLFEGA) has more advantages to reduce postoperative complications of anastomotic leak, stricture and GER.

Keywords: $[Keywords]