[Shortcomings of esophagogastric stapling device and their correction and prevention].

From 1985 to 1991, 202 patient with cancer of the esophagus or gastric cardia were resected with esophagogastric stapling device. The shortcomings were: 1. Necessity of second stapling-5 cases, and 2. Defective performance-9.1% (19/207 times) which was due to; a. failed coupling (7 times), b. incomplete resection (6 times), c. tearing of the muscular layer (4 times), d. gastric tube stapled into the stoma (1 time), and e. fall-off of thread from the purse-string suture at the esophageal stump (1 time). The correction procedures were: 1. Repair by hand suture (6 times), 2. Repeated stapling (5 times), 3. Repair of muscle tear by silk sutures (6 times), and 4. Second resection (2 times). Prevention of these shortcomings are discussed. The authors believe the stapling device can not replace manual suturing.