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Oesophagogastrectomy using stapling instruments.

D K Kaplan1, R I Whyte, R J Donnelly

  • 1Regional Adult Cardiothoracic Unit, Broadgreen Hospital, Liverpool, UK.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|January 1, 1988
PubMed
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Stapling instruments and left thoracotomy improve outcomes for oesophagogastrectomy. This surgical approach for oesophageal cancer shows reduced mortality and comparable complication rates, enhancing patient recovery.

Area of Science:

  • Surgical Oncology
  • Gastrointestinal Surgery
  • Thoracic Surgery

Background:

  • Oesophagogastrectomy is the standard surgical treatment for resectable oesophageal tumours.
  • Minimally invasive techniques are increasingly explored to improve surgical outcomes.

Purpose of the Study:

  • To evaluate the efficacy and safety of using stapling instruments for oesophagogastrectomy.
  • To assess the outcomes of employing a left thoracotomy approach for specific oesophageal and gastric cardia lesions.

Main Methods:

  • Retrospective analysis of 164 patients undergoing oesophagogastrectomy between January 1980 and December 1986.
  • Comparison of outcomes between patients who had stapling instruments used for resection and anastomosis versus traditional methods.
  • Subgroup analysis of 75 patients who underwent the procedure via a left thoracotomy approach.

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Main Results:

  • Overall peri-operative mortality was 7.9%, with a complication rate of 17%.
  • Anastomotic leakage occurred in 1.8% and strictures in 9.7% of patients.
  • The left thoracotomy subgroup showed a lower mortality rate (5%) but a higher complication rate (23%), with a leak rate of 3% and stricture rate of 12%.

Conclusions:

  • The use of stapling instruments in oesophagogastrectomy is associated with acceptable morbidity and mortality.
  • The left thoracotomy approach for specific oesophageal lesions demonstrates feasibility with a reduced mortality risk, though careful patient selection is warranted due to a higher complication rate.