Double layered anastomosis in thoracoscopic and laparoscopic esophagectomy

Abstract

Objective To summarize the experience of double layered anastomosis in thoracoscopic and laparoscopic esophagectomy, and to explore its impact on the postoperative anastomotic complications. Methods Patients with thoracoscopic and laparoscopic esophagectomy from September 2014 to Auguest 2015 were retrospectively included. The cervical anastomosis were conducted by hand-sewn double layered anastomosis on the posterior wall of the gastric remnant, with the anastomotic configuration of end-to-side. The patients’ general information and postoperative complications were recorded and analyzed. Results 45 patients with esophageal squamous cell carcinoma were included. The major postoperative complications were gastric dilatation(6/45, 13.3%), hoarseness(5/45, 11.1%), anastomotic leak/gastric necrosis(2/45, 4.4%), anastomotic stricture(0/45, 0). All patients were discharged from hospital with no perioperative death. Conclusion Hand-sewn double layered anastomotic technique could be safely used in thoracoscopic and laparoscopic esophagectomy, which could assure the security of the anastomosis. The anastomotic complication rates for this technique are rare enough to be recommended, as compared with other anastomotic methods reported in the literatures. Key words: Thoracoscopic and laparoscopic esophagectomy; Minimally invasive esophagectomy; Double layered anastomosis