Comparison of three ways of anastomosis in the application of thoracoscopic esophagectomy

Abstract

Objective To assess the related anastomotic complications of cervical esophagogastric anastomosis among the sheath-style anastomosis, the manual monolayer anastomosis and the stapled anastomosis in thoracoscopic esophagectomy. Methods The clinical data of 175 patients with esophageal cancer receiving combined thoracoscopic and laparoscopic esophagectomy from January 2013 to December 2015 were retrospecctively analyzed.All the patients were divided into sheath-style anastomosis group (55 cases), manual monolayer anastomosis group (59 cases) and stapled anastomosis group (61 cases)according to the anasomosis in the neck. The incidences of anastomotic leakage, anastomotic stricture and anastomotic regurgitation among the groups were compared. Results There was no significant difference among the groups in gender, age, tumor stage, tumor location or body mass index (all P>0.05). The incidences of anastomotic leakage in the sheath-style anastomosis group, the manual monolayer anastomosis group and the stapled anastomosis group were respectively 1.8%(1/55), 15.3%(9/59) and 9.8%(6/61), while the difference was significant between manual monolayer anastomsis group and stapled anastomosis group(P 0.05], while the differences were significant in other groups[21.8%(12/55)vs 52.5%(31/59), 21.8%(12/55)vs 63.9%(39/61), P all<0.05]. Conclusions In the thoracoscopic esophagectomy, cervical esophagogastric sheath-style anastomosis can reduce the risk of anastomotic related complications, therefore the type of anastomosis is safe. Key words: Esophageal cancer; Thoracoscopy; Sheath-style anastomosis; Manual monolayer anastomosis; Stapled anastomosis