caa a22 4500 47577938X CHVBK 20180406123640.0 cr unu---uuuuu 170329e20000701xx s 000 0 eng 10.1007/s004640000020 doi (NATIONALLICENCE)springer-10.1007/s004640000020 Anastomotic stenoses occurring after circular stapling in esophageal cancer surgery [Elektronische Daten] [G. Petrin, A. Ruol, G. Battaglia, F. Buin, S. Merigliano, M. Constantini, P. Pavei, M. Cagol, S. Scappin, E. Ancona] Background: Circular staplers have reduced the incidence of anastomotic leaks in esophagovisceral anastomosis. However, the prevalence of stenosis is greater with staplers than with manual suturing. The aim of this study was to analyze potential risk factors for the onset of anastomotic stenoses and to evaluate their treatment and final outcome. Methods: Between 1990 and 1995, 187 patients underwent esophagectomy and esophagogastrostomy with anastomosis performed inside the chest using a circular stapler. Results: Twenty-three patients (12.3%) developed an anastomotic stenosis. The incidence of strictures was inversely related to the diameter of the stapler. Concomitant cardiovascular diseases; morphofunctional disorders of the tubulized stomach, such as those related to duodenogastric reflux; and neoadjuvant chemotherapy were also recognized as significant risk factors. Endoscopic dilatations proved safe and were effective in the treatment of most anastomotic stenoses. Conclusions: To reduce the risk of anastomotic stenosis after stapled intrathoracic esophagogastrostomy, adequate vascularization of the viscera being anastomized should be maintained, and it is mandatory to use the largest circular stapler suitable. Furthermore, it is essential to reduce the negative inflammation-inducing effects of duodenogastroesophageal reflux to a minimum. Endoscopic dilatations are safe and effective in curing the great majority of anastomotic stenoses. Springer-Verlag New York Inc., 2000 Key words: Anastomic stenosis — Endoscopic dilatation — Esophagogastrostomy — Stapled anastomosis nationallicence Petrin G. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut Ruol A. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut Battaglia G. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut Buin F. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut Merigliano S. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut Constantini M. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut Pavei P. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut Cagol M. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut Scappin S. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut Ancona E. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut Surgical Endoscopy Springer-Verlag 14/7(2000-07-01), 670-674 0930-2794 14:7<670 2000 14 464 https://doi.org/10.1007/s004640000020 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640000020 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Petrin G. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut NATIONALLICENCE 700 1- Ruol A. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut NATIONALLICENCE 700 1- Battaglia G. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut NATIONALLICENCE 700 1- Buin F. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut NATIONALLICENCE 700 1- Merigliano S. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut NATIONALLICENCE 700 1- Constantini M. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut NATIONALLICENCE 700 1- Pavei P. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut NATIONALLICENCE 700 1- Cagol M. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut NATIONALLICENCE 700 1- Scappin S. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut NATIONALLICENCE 700 1- Ancona E. Clinica Chirurgica Generale 4, Dipartimento di Scienze Mediche e Chirurgiche, University of Padova School of Medicine & Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy, Italy aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/7(2000-07-01), 670-674 0930-2794 14:7<670 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer