J.Jpn. Surg. Soc.. 83(9): 882-886, 1982

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Report on the annual meeting

MASURES FOR SUTURE INSUFFICIENCY OF ANTE-THORACIC ESOPHAGOGASTROSTOMY

In studying the problems of suture insufficiency of ante-thoracic esophagogastrostomy, we must classify it into minor leakage and major leakage. In this report the lumen of an esophagogastric anastomosis was regarded as a circle. Thus the leakage shown to occupy less than 1/8 of the circle belonged to the minor leakage, and the other to the major leakage if found to extend more than 1/8 of the circle.
It is likely that minor leakage has been mostly caused by the technique of operation and the major leakage by the trouble with blood supply in the gastric tube. Mechanoanastomosis using EEA has been effective for preventing minor leakage.
The following approach was attempted for preventing major leakage: After splenectomy, we have made a gastric tube whose short gastric artery remained to keep blood supply.
Effectiveness of this method was accepted when applied to the experimental animals and to the clinical cases, whose blood supply was measured at regular intervals. Only one of ten clinical cases we have treated was shown to involve the minor leakage. An effective method for the improvement of suture insufficiency of ante-thoracic esophagogastrostomy is to make such a gastric tube as stated above, and to perform anastomosis using EEA.

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