[Telescopic anastomosis in esophageal and gastric surgery]

In 1991 we tried to adopt the telescopic anastomosis technique which had been used in bowel surgery made with the esophagus. In our method a 1.5-2 cm long stump of the distal esophagus is laid in the lumen end-to-side of the other organ (stomach, jejunum, large bowel). The oral the worst blood supplied part of the stomach has also removed and an end-to-end anastomosis has been made. We used this method in 125 patients until the end of 1997. In 89 cases during esophageal resections, and from it in 36 cases the anastomoses were made and-to-end, in 36 cases during total gastrectomies were made telescopic anastomosis leakage in the neck that healed after conservative treatment. We noticed advanced ischemic necrosis of the stomach used for replacement in 4 cases. Two of these patients healed after operative treatment. After gastrectomies all anastomosis healed without any complication. In 6 cases occurred anastomotic stenosis always after anastomotic leakage. 3 patients could be treated with dilatation, in 3 cases had to make reoperations due to stenosis. The authors emphasize that the method is simple, made in single lawyer, the sutures are not drained the lumen. They have not got strong opinion about the propensity for stenosis due to few cases.