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Updated: Apr 23, 2026
An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
[Application of cervical triangulating stapled anastomosis in minimally invasive esophagectomy]
Lijie Tan1, Mingxiang Feng, Yaxing Shen
1Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China. doctorwangqun@aliyun.com.
Objective:
To explore the safety and feasibility of cervical triangulating stapled anastomosis(TSA) for esophagogastric anastomosis(EGA) after minimally invasive esophagectomy (MIE).
Methods:
Clinical data of 137 patients undergoing MIE for esophageal cancer(EC) in our department from January 2013 to March 2014 using end to side circular stapled anastomosis (CSA, 60 cases) or end-to-end triangulating stapled anastomosis (TSA, 77 cases) in the neck were retrospectively analyzed. The short-term outcomes between the two groups were evaluated and compared.
Results:
Cervical anastomotic leakage occurred in 3 patients(3.9%) of TSA group, but in six(10.0%) of CSA group (P=0.152). The incidence of anastomotic stenosis was 1.3%(1/77) and 15.0%(9/60) in TSA and CSA group respectively(P=0.002). The median hospital stay and perioperative mortality were not significantly different between the two groups as well as postoperative respiratory and cardiovascular complications.
Conclusions:
TSA is a safely and effectively alternative method for EGA with lower incidence of postoperative gastrointestinal complications, especially in anastomotic stricture.
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