[Surgical treatment of carcinoma of the esophagus: automatic suture versus manual suture].

The authors have reviewed the anastomosis and sutures utilized for the surgical treatment of 38 patients with carcinoma of the esophagus and cardia. They have compared results following the stapled anastomosis and sutures with those following hand sutured procedures (30 anastomosis and 13 sutures) performed by the same group of surgeons. The stapled anastomosis were performed utilizing a new circular stapling device and gastric and jejunal stapled sutures, utilizing Nakayama's clamp. When anastomosis and sutures were performed by hand suturing, standard techniques were utilized. Patients were grouped in three categories: Group I if the gastric or jejunal sutures or the esophagogastric or esophagojejunal anastomosis were hand sutured; Group II wherein both stapled and hand sutures were performed; Group III when the esophageal anastomosis and related sutures were all performed by stapling devices. Different factors with possible adverse effect on suture healing were also studied. The incidence of suture related complications ranged between 4,2 and 29,1% for Group I; 1,8 and 19,2% for Group II; 0 and 16,2% for Group III. The 60-day operative mortality rate was 23% for Group I (8,4-50,9%), 17,64% for Group II (6,4-25,9%) and 0% (0-28,3%) for Group III. It is felt that better results were obtained with stapled sutures.