R. Bardini et al., SINGLE-LAYERED CERVICAL ESOPHAGEAL ANASTOMOSES - A PROSPECTIVE-STUDY OF 2 SUTURING TECHNIQUES, The Annals of thoracic surgery, 58(4), 1994, pp. 1087-1089
We carried out a prospective, randomized study over a I-year period to
compare the efficacy of a single layer of continuous absorbable monof
ilament (Maxon) with that of a single layer of interrupted Polyglactin
sutures (Vicryl) in the performance of cervical esophagogastric anast
omoses. Forty-two consecutive patients with carcinoma of the esophagus
or cardia, in whom the stomach was transposed through the mediastinal
route after esophagectomy, were enrolled in the study. There were 21
patients in each group. There was no hospital mortality. One asymptoma
tic anastomotic leak and two early anastomotic strictures requiring di
lation occurred in patients in whom an interrupted technique was emplo
yed. The continuous technique required significantly less operative ti
me (p < 0.0001), and the cost of the suture material was reduced marke
dly. We conclude that either a continuous or an interrupted monolayer
esophagogastric anastomosis can give satisfactory results after esopha
gectomy for cancer, provided that the vascular supply to the gastric f
undus is maintained adequately. The continuous technique has the advan
tages of being time-saving, cheaper, and easier to perform and to teac
h.