DELAYED CERVICAL ANASTOMOSIS OF THE ESOPHAGUS FOR ESOPHAGEAL-CARCINOMA

Background. The surgical approach for patients with advanced epidermoi d esophageal carcinoma should provide an effective palliative effect w ith morbidity ratio as low as possible, Anastomotic leakage is a frequ ent complication and may be responsible for both early and late morbid ity and, therefore, we assessed the role of delayed cervical esophagov isceral anastomosis technique in relation to the incidence of anastomo tic complications, Methods. Eight patients (Group I)and 12 patients (G roup 2) submitted to one-stage or two-stage operation, respectively, w ere selected by an intraoperative assessment by the surgeon, consideri ng mainly tissue blood flow of the replacement organ after its placeme nt in the cervical region, Results, In Group 1 anastomotic dehiscence was observed in 37.5% of patients, while in Group 2 no cases of dehisc ence occurred (p = 0.049), However, the postoperative mortality rate d id not differ between the two groups (12.5% versus 0%, NS), Conclusion . When organ viability is uncertain, esophagovisceral anastomosis is b est done by two-stage operation, since it decreases the incidence of a nastomotic leak.