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Related Experiment Video

Updated: Apr 28, 2026

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
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Cervical triangulating stapled anastomosis: technique and initial experience.

Jingpei Li1, Yaxing Shen1, Lijie Tan1

  • 11 Division of Thoracic Surgery, Zhongshan Hospital of Fudan University, Shanghai 200032, China ; 2 Department of Cardio-thoracic Surgery, Jingjiang People's Hospital, Jingjiang 214500, China.

Journal of Thoracic Disease
|May 31, 2014
PubMed
Summary
This summary is machine-generated.

Modified cervical triangulating stapled anastomosis (TSA) is a safe and effective option for gastroesophageal anastomosis (GEA) during minimally invasive esophagectomy (MIE). This technique may reduce the rates of anastomotic leakage and stenosis following MIE.

Keywords:
Esophageal cancer (EC)gastroesophageal anastomosis (GEA)minimally invasive esophagectomy (MIE)triangulating stapled anastomosis (TSA)

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Area of Science:

  • Surgical Oncology
  • Gastroenterology
  • Minimally Invasive Surgery

Background:

  • Gastroesophageal anastomosis (GEA) is a critical step in minimally invasive esophagectomy (MIE).
  • Traditional circular stapled (CS) techniques may be associated with complications such as anastomotic leakage and stenosis.
  • Modified cervical triangulating stapled anastomosis (TSA) offers a potential alternative for GEA.

Purpose of the Study:

  • To evaluate the safety and efficacy of modified cervical TSA for GEA in MIE.
  • To compare the outcomes of TSA versus CS for GEA in MIE patients.

Main Methods:

  • A prospective study included 84 patients undergoing three-stage MIE from January to November 2013.
  • Patients received either CS or modified TSA for GEA during the cervical stage.
  • Clinical features and postoperative outcomes were collected and compared between the two groups.

Main Results:

  • Intraoperative GEA duration was similar between TSA and CS groups (17±2.7 min vs. 18±3.4 min).
  • Postoperative cervical anastomotic leakage occurred in 3.0% of TSA patients versus 11.8% of CS patients.
  • The overall incidence of postoperative complications was significantly lower in the TSA group (15.2%) compared to the CS group (35.3%).
  • Anastomotic stenosis incidence was lower in the TSA group (0.0%) than in the CS group (13.7%).

Conclusions:

  • Modified cervical TSA is a safe and effective method for GEA in MIE.
  • TSA may lead to a reduced incidence of anastomotic leakage and stenosis.
  • Larger volume studies are warranted to further validate these findings.