594 HAND-SEWN CERVICAL ESOPHAGOGASTRIC ANASTOMOSIS AFTER ESOPHAGECTOMY

Successful anastomosis is essential in esophagogastrectomy. Staplers are more popularly applied for the anastomosis. However, a hand-sewn anastomosis is a basic and cost-effective method. Herein, we introduce our technical tips of all hand-sewn cervical esophagogastric anastomosis. Methods Step 1: A 6 cm gastric tube is created and pulled up through the posterior mediastinal route. Step 2: A single layer Gambee sutures are used to approximate the cervical esophagus and the posterior wall of the gastric tube in end-to-side fashion. Step 3: The redundant part in the gastric tube apex is removed. Results We analyzed 199 consecutive patients who underwent this anastomosis in our institute from 2004 to 2019. There was no postoperative mortality. Anastomotic leak (Clavien-Dindo classification; Grade ≥ II) rate was 2.5%. Anastomotic stricture which required balloon dilation was 3.5%. Conclusion The anastomotic complication rates in the hand-sewn anastomosis were comparable to those of the mechanical stapled anastomosis in the previous reports. Video https://www.dropbox.com/s/sxnxs4962aj5n5k/anastomosis.mp4?dl=0.