当科での食道癌手術における器械吻合導入後の成績

Abstract

We have utilized a circular stapler for intra-thoracic anastomosis (ITA) after radical esophagectomy since July 1999, and moreover, for cervical anastomosis (CA) since July 2001. In this study，we evaluate the usefulness of esophagogastric anastomosis with a circular stapler. Subjects were 28 esophageal patients who underwent esophagectomy followed by esophagogastric anastomosis with a circular stapler in the period from July 1999 to February 2003. Esophagogastric anastomosis with a circular stapler was performed by end to side anastomosis. Subjects consisted of 20 cases undergoing ITA and 8 cases undergolng CA. The incidences of anastomotic leakage were 15.0％ and 12.5％, respectively. The cases with anastomotic leakage were treated with a conservative therapy and cured. The incidences of anastomotic stenosis in ITA and CA were 15.0％ and 12.5％, respectively. Anastomotic stenosis occurred from one to six months after operation in the cases without anastomotic leakage. One or two balloon dilatation could not relieved in 3 of the 4 cases with anastomotic stenosis. Anastomotic bleeding was not found. There was only one case with severe reflex esophagitis in ITA. We are almost satisfied with these results. Therefore, it was thought that esophagogastric anastomosis with a circular stapler isuseful.