Cervical esophagogastric anastomosis: results following esophagectomy for carcinoma

We reviewed our experience with 262 consecutive two-layer, hand-sewn cervical esophageal anastomoses in patients undergoing surgery for esophageal carcinoma. Anastomotic leak rates were determined for the entire group and the frequency of post-operative esophageal dilatations was obtained for the first 101 patients. It was assumed that the frequency of dilatations would reflect the frequency of anastomotic strictures. The overall leak rate was 0.8% (two patients). Overall hospital mortality was 2.7%. No patient died as a result of anastomotic leakage. In our series, 26% of patients required at least one dilatation. If a dilatation was needed, the majority occurred within the first 6 months. We conclude that using a standardized, two-layer hand-sewn anastomotic technique cervical esophageal anastomoses may be performed safely with results similar to those reported using intrathoracic techniques.