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[Cervical esophagogastrostomy with circular mechanical stapler in the treatment of esophageal carcinoma--report of 346 cases].

OBJECTIVE
To evaluate the efficacy of esophagogastrostomy in the neck using circular mechanical stapler through the esophageal bed.


METHODS
From March 1998 to June 2004 subtotal esophagectomy and mechanical anastomosis with stomach in the neck through the esophageal bed was carried out in 346 esophageal cancer patients.


RESULTS
In this series, the positive rate of detecting residual cancer cells in the esophageal stump was 1.2% (4/346); anastomotic fistula was observed in 5.5% (19/346) causing one patient died; the overall operative mortality rate was 0.6% (2/346); esophageal anastomotic stricture developed in 3.8% (13/346), which were cured by endoscopic dilatation.


CONCLUSION
This modified operation mode has low rate of complication, reducing impairement to pulmonary function due to the transposed thoracic stomach within the mediastinum instead of the thoracic cavity. Using mechanical circular stapler for anastomosis in the neck simplifies the operation and reducing the postoperative risk caused by anastomotic leak.