Objective: To evaluate the application of circular stapler in upper digestive tract reconstruction.
Methods: We present a retrospective review of 3322 patients with Carcinoma of esophagus and cardia undergoing a stapled esophagogastric anastomosis from August 1980 to September 2004. There were 2642 males and 680 females with age ranged from 28 to 83 years old. Carcinoma of esophagus was present in 2312 patients and carcinoma of gastric cardia in 1010 patients. The anastomosis was performed in the cervical region in 102 cases, thoracic apex in 147 cases, up aortic in 1838 cases and below aortic in 1235 cases.
Results: Anastomotic leakage occurred in 18 patients with an overall incidence of 0.54%, including thoracic leakage in 11 cases and cervical leakage in 7 cases. nine patients were dead because of the thoracic leakage, and the mortality of thoracic leakage was 81.8%. Benign anastomotic stricture was found in 66 patients with a rate of 2.0%, and instrumental failure occurred in 36 patients with a rate of 1.1%.
Conclusion: Circular stapler can be used safely and reliably in upper digestive tract surgery, and the stapled anastomosis is an effective technique to reduce the incidence of anastomotic leakage.