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Complications after esophagogastrectomy using stapling instruments.

D D Muehrcke1, R J Donnelly

  • 1General Surgical Service, Massachusetts General Hospital, Boston 02114.

The Annals of Thoracic Surgery
|August 1, 1989
PubMed
Summary
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Esophageal resection using stapling instruments can lead to complications like anastomotic leaks. Choosing a smaller stapling device head may reduce leaks, and strictures are manageable with dilation.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Thoracic Surgery

Background:

  • Esophageal resection is a critical procedure for malignant and benign diseases.
  • Stapling instruments are commonly used to create anastomoses during esophageal surgery.
  • Complications associated with stapling can impact patient outcomes.

Purpose of the Study:

  • To evaluate the safety and complications of stapling instruments in esophageal resection.
  • To identify specific stapler-related complications and their incidence.
  • To provide recommendations for minimizing stapler-related adverse events.

Main Methods:

  • Retrospective analysis of 195 patients undergoing esophageal resection over 8.5 years.
  • Data collection on operative details, complications, and outcomes.

Related Experiment Videos

  • Specific focus on stapler-related issues, including leaks and esophageal tears.

    • Main Results:

    • 91.2% of patients had surgery for malignant disease; operative mortality was 9.7%.
    • Stapler-related complications occurred in 4.6% of patients, including 1.0% operative deaths.
    • Anastomotic leaks and gastrotomy staple line leaks were most frequent (4 each); esophageal tears by circular stapler led to leaks in 43% of affected patients.

    Conclusions:

    • Oversewing gastrotomy staple lines significantly reduced leaks after 1984.
    • Using a smaller stapling head for esophageal anastomosis may decrease leak incidence.
    • Postoperative strictures are manageable with dilation, suggesting a preference for smaller stapler heads to prevent leaks.