[Trans-sutural mechanical anastomosis in esophagogastric surgery. Apropos of 25 cases].

The essential point conditioning the success of a mechanical esophagogastric or esophagojejunal anastomosis is the performance of an esophageal purse. The authors present a variety of the technique which consists of replacing the esophageal purse by a linear stapling after having introduced the anvil in esophagus. The anvil shaft is then exteriorized through the staple line. From January 1991 to January 1994, this technique was performed on 25 patients (17 men and 8 women), with a mean-age of 66 years (range 27 to 83). The esophagojejunal anastomosis after total gastrectomy was performed on 17 patients (15 carcinomas, 1 acute gastritis with gastric haemorrhage, 1 stomal ulcer), and the esophagogastric anastomosis after partial esophagectomy for carcinoma on 8 patients. After six to twelve months neither an anastomotic stenosis nor a leakage occurred. The advantage of this technique is on one hand to simplify the performance of the anastomosis and to reduce the septic and operating time, on the other hand to avoid the complications of performing the esophageal purse.