DOUBLE STAPLING METHOD OF ANASTOMOSIS AFTER ESOPHAGECTOMY WITH ENDOSCOPIC STAPLER TO PREVENT POSTOPERATIVE STRICTURE

To prevent stricture of an anastomotic site after operation of esophag eal cancer, a new surgical technique, the ''double-stapling method,'' was designed and applied clinically to 29 patients. According to the s urgical technique, an automatic suture device for endoscopy was insert ed from the side of the lesser curvature of the stomach to the esophag eal side after performing end-side anastomosis between the esophagus a nd the stomach tube using a conventional circular anastomotic device t o perform anastomosis between the anterior wall of the esophagus and t he posterior wail of the stomach tube. As a result, a conventional ana stomotic site, which was a plane (two dimensional), was transformed in to a three-dimensional configuration. In the postoperative measurement of the anastomotic site using a measurement forceps, the inner diamet er of the site was 8.6 +/- 3.1 mm in the circular group, while it was 17.2 +/- 4.5 mm in the DS group, showing a significant difference (p < 0.0001). Minor leakage was observed in three patients as a postoperat ive complication, but no postoperative hemorrhage occurred.