Pre-embedded cervical circular stapled anastomosis in esophagectomy.

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Minimally Invasive Surgery

Background:

• Mechanical anastomosis is standard for esophageal cancer surgery.
• Anastomotic fistula remains a critical complication, particularly in cervical anastomosis.
• Limited space in cervical anastomosis hinders conventional embedding techniques.

Purpose of the Study:

• To introduce an improved embedded method for cervical circular stapled anastomosis.
• To evaluate the efficacy of this technique in reducing anastomotic complications.
• To provide procedural details for a smooth pre-embedded technique.

Main Methods:

• 31 patients undergoing minimally invasive esophagectomy were enrolled.
• A pre-embedded cervical esophagogastrostomy using a circular stapler was performed.
• Data on surgical duration, blood loss, hospitalization, and complications were recorded.

Main Results:

• The average operative time was 260.3 minutes.
• No anastomotic fistulas, strictures, or pulmonary complications were observed.
• Two cases of gastroesophageal reflux occurred, with an average hospital stay of 10.3 days.

Conclusions:

• Pre-embedded cervical circular stapled anastomosis is a viable alternative for select patients.
• This method can decrease anastomotic fistula rates through full peripheral embedding.
• The technique offers a significant reduction in anastomotic leakage risk.