[Mechanical anastomoses in esophagogastric surgery for malignant tumors]

The authors present their experience in employing for the first time the mechanical circular suture with I.L.S. stapler in the surgery of 10 malignant esophagogastric tumors sited in C (4 cases) and M areas (6 cases). The disease was in stage II in 2 patients and in stage III in the remainder of 4. Three upper polar esophagogastrectomies (Akiyama technique) and 7 total gastrectomies were performed in old patients (mean age 63 years) at high surgical risk. Neither death nor fistulas were recorded. The average hospital stay was 14 days. A series of 17 patients (mean age 59 years), at medium surgical risk, with total gastrectomy for gastric carcinoma and classical suture served as controls. Five fistulas, two deaths and a two times longer hospital stay were recorded. Although the high cost of staplers prohibits the routine use of this technique, the authors demonstrate the great advantages resulting from mechanical suture in esophagogastric surgery.