Esophagogastrectomy with use of a single gastrotomy for pyloromyectomy and insertion of EEA stapler and gastrostomy tube.

A technique of esophagogastrectomy is described in which a single gastrotomy permitted insertion of an end-to-end circumferential stapler for esophagogastric anastomosis, a transgastric pyloromyectomy, and placement of a gastrostomy tube. A transgastric pyloromyectomy was easy to perform and functioned adequately. The stapler could be advanced via the gastrotomy into the mediastinum or the upper thorax for the anastomosis. The placement of a gastrostomy tube obviated the need for prolonged use of a nasogastric tube, thus removing a major cause of discomfort. Use of this technique in 20 patients simplified the operative procedure and the postoperative care.