SINGLE-LAYERED CERVICAL ESOPHAGEAL ANASTOMOSES - A PROSPECTIVE-STUDY OF 2 SUTURING TECHNIQUES

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.