eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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vol. 18
General surgery
Original paper

Application of reversely connecting circular stapler technique in cervical esophagogastric anastomosis

Minglei Song
Liping Gao
Junfeng Liu
Fumin Cao

Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
Videosurgery Miniinv 2023; 18 (2): 279–286
Online publish date: 2023/03/09
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The incidence of anastomotic leakage is relatively high (6–26%) in esophagogastrocervical anastomosis. The traditional anastomotic mode has high tissue tension in the process of anastomosis, which can easily cause tissue tear in the anastomotic area and increase the incidence of anastomotic leakage.

To investigate the usefulness of reversely connecting circular stapler technique for reducing anastomotic tension and injury of the esophageal and gastric wall, preventing anastomotic leakage in minimally invasive McKeown esophagectomy.

Material and method
A total of 133 patients with esophageal cancer who underwent minimally invasive McKeown esophagectomy from January 2021 to December 2021 were collected. Characteristics, surgical data, and outcomes of patients were recorded and retrospectively analyzed. There were 83 patients in the reverse order connecting circular stapler group and 50 patients in the conventional order connecting group.

Anastomotic leakage was observed in 2 (2.4%) cases in the reverse order connecting circular stapler group. Compared with the conventional connection group, the reverse connecting group had lower incidence of anastomotic leakage, shorter anastomotic time, shorter hospital stay, and lower incidence of pulmonary and chest infections and hoarseness.

The reversely connecting circular stapler technique could reduce the incidence of anastomotic leakage. The technique is simple to perform and easy to learn. Therefore, it is useful for the prevention of anastomotic leakage.


anastomosis, esophageal tumor, esophagectomy, digestive tract reconstruction

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