Experience with the EEA stapler for esophagojejunostomy

From January 1979 through December 1986, 239 patients underwent total gastrectomy for gastric cancer. In 94 patients esophagojejunostomy was performed with the EEA stapler and in 145 patients hand sutures were employed. Operating time (mean +/- SD) was 288 +/- 60 minutes in the stapled group and 306 +/- 75 minutes in the sutured group (p less than 0.05). The length of the resected esophagus (mean +/- SD) was 19 +/- 17 mm in the former and 14 +/- 14 mm in the latter (p less than 0.01). The rate of leakage was 7.4% in the former and 13.8% in the latter with no significant difference. Five patients (3.4%) died within 30 days after sutured anastomosis and in two of them death was caused by anastomotic leakage. There was no operative death in the stapled group. It seemed that the stapler was able to simplify and facilitate esophagojejunostomy after total gastrectomy and that anastomosis with the stapler was at least as reliable as that with hand sutures.