Analysis of outcomes of a transoral circular stapled anastomosis following major upper gastrointestinal cancer resection

TY - JOUR

T1 - Analysis of outcomes of a transoral circular stapled anastomosis following major upper gastrointestinal cancer resection

AU - Foley, Daniel M.

AU - Emanuwa, Emudiaga J.E.

AU - Knight, William R.C.

AU - Baker, Cara R.

AU - Kelly, Mark

AU - McEwan, Ricardo

AU - Zylstra, Janine

AU - Davies, Andrew R.

AU - Gossage, James A.

N1 - Publisher Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: [email protected].

PY - 2021/11/11

Y1 - 2021/11/11

N2 - BACKGROUND: Esophageal anastomoses performed following esophagectomy and total gastrectomy are technically challenging with a significant risk of anastomotic leak. A safe, reliable, and easy anastomotic technique is required to improve patient outcomes and reduce morbidity. METHOD: This paper analyses 328 consecutive patients who underwent transoral circular stapled esophageal anastomosis (ORVIL™) from a prospectively collected single-center database between December 2011 and February 2019. RESULTS: Two hundred and twenty-seven esophagectomies and 101 gastrectomies were performed using OrVil™ anastomoses. The mean patient age was 63.7 years. Of 328 consecutive OrVil™-based anastomoses, there were 10 clinically significant anastomotic leaks requiring radiological or operative intervention (3.05%). Twenty-eight (8.54%) patients developed anastomotic stricture, all of which were successfully treated with endoscopic balloon dilatation (a median of 1 dilatation was required per patient). CONCLUSION: The OrVil™ anastomotic technique is reliable and safe to perform. This is the largest reported series of the OrVil™ anastomotic technique to date. Leak rates and anastomotic dilations were similar to other reported series. Based on our experience, we consider the use of the OrVil™ device for reconstruction after major upper GI resection to be safe and reliable.

AB - BACKGROUND: Esophageal anastomoses performed following esophagectomy and total gastrectomy are technically challenging with a significant risk of anastomotic leak. A safe, reliable, and easy anastomotic technique is required to improve patient outcomes and reduce morbidity. METHOD: This paper analyses 328 consecutive patients who underwent transoral circular stapled esophageal anastomosis (ORVIL™) from a prospectively collected single-center database between December 2011 and February 2019. RESULTS: Two hundred and twenty-seven esophagectomies and 101 gastrectomies were performed using OrVil™ anastomoses. The mean patient age was 63.7 years. Of 328 consecutive OrVil™-based anastomoses, there were 10 clinically significant anastomotic leaks requiring radiological or operative intervention (3.05%). Twenty-eight (8.54%) patients developed anastomotic stricture, all of which were successfully treated with endoscopic balloon dilatation (a median of 1 dilatation was required per patient). CONCLUSION: The OrVil™ anastomotic technique is reliable and safe to perform. This is the largest reported series of the OrVil™ anastomotic technique to date. Leak rates and anastomotic dilations were similar to other reported series. Based on our experience, we consider the use of the OrVil™ device for reconstruction after major upper GI resection to be safe and reliable.

KW - esophagectomy

KW - gastrectomy

KW - OrVil™

KW - upper GI

UR - http://www.scopus.com/inward/record.url?scp=85121966609&partnerID=8YFLogxK

U2 - 10.1093/dote/doab004

DO - 10.1093/dote/doab004

M3 - Article

C2 - 33554244

AN - SCOPUS:85121966609

SN - 1120-8694

VL - 34

JO - Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus

JF - Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus

IS - 11

ER -