A procedure to elongate the stomach tube in the esophageal replacement

When the stomach tube has to be lengthened in case of antethoracic esophageal replacement, a circumferential seromuscular incision is made and the lesser curvature side of the tube is cut through, in the same line of incision. The rent produced is longitudinally suture-closed, by which a definite elongation (about 2 cm by each incision) is obtained. In our department the antethoracic use of the stomach tube has been carried out since 1968, the elongation procedure was started in 1973 as a trial, then its application became more frequent since 1978 and was performed whenever the tube seemed to be deficient in length. The stomach tube was used in 40 cases, of which 17 underwent the elongation procedure. With regard to the suture leak at the site of the antethoracic esophagogastric anastomosis, the incidence was 50 per cent from 1968 to 1972, 54 per cent from 1973 to 1977 and 22 per cent in the last 5 years. Thus, a distinct improvement has occurred with time.