Anastomotic narrowing after esophagogastrectomy with the EEA stapling device

Area of Science:

• Gastroenterology
• Surgical Oncology
• Thoracic Surgery

Background:

• Esophageal resection is a critical procedure for managing esophageal diseases.
• The EEA surgical stapling device has become a common tool for esophageal anastomosis.
• Anastomotic complications, such as strictures and dysphagia, remain a concern.

Purpose of the Study:

• To evaluate the incidence and causes of dysphagia after esophageal resection using the EEA surgical stapler.
• To identify risk factors associated with anastomotic narrowing and dysphagia.
• To assess the outcomes of interventions for dysphagia.

Main Methods:

• Retrospective analysis of 176 patients undergoing esophageal resection with the EEA stapler over 7.5 years.
• Data collection on patient demographics, disease type, surgical details, and postoperative complications.
• Assessment of dysphagia prevalence, anastomotic narrowing, and need for dilatation.

Main Results:

• Overall dysphagia prevalence was 17.4%, with benign anastomotic narrowing in 12.5% of patients.
• Patients resected for benign strictures had a higher rate of anastomotic narrowing (37.5%) compared to malignant disease (9.6%).
• Most benign anastomotic narrowings (95%) presented within 6 months and required ≤2 dilatations.

Conclusions:

• Dysphagia is a significant complication after EEA stapler esophagectomy, primarily due to benign anastomotic narrowing.
• Patients with benign strictures are at higher risk for anastomotic narrowing.
• Benign anastomotic narrowing is generally manageable with dilatation, offering a positive prognosis for most patients.