Single layer suture by manual or mechanical stapling technique in esophagojejunostomy after total gastrectomy

Manual single layer suturing procedures were used for esophagojejunostomy in end-to-side fashion after total gastrectomy in 30 patients with upper gastric carcinoma involving the esophagus. Only one minor suture line leak was observed in spite of the anastomosis without any other seromuscular reinforcing sutures. Transabdominal, highly placed intramediastinal esophagojejunostomy was made by mechanical suturing; the instrument proved simple to use and produced a reliable closure of good quality in 14 patients with esophgogastric cancer. Suture line leak was seen in two patients in whom this one layer inverting stapling suture technique was used. Post-operative barium roentgenography of the anastomosis by these two methods showed a stoma wide enough to pass any kind of food without stenosis in all successful cases.