Three years' experience with esophageal stapling device.

The authors report their experience with forty patients undergoing resection of middle and lower thirds carcinomas of the esophagus or proximal stomach, with esophagogastric or esophagojejunal anastomosis using an end-to-end anastomosis (EEA) stapler. A fatal anastomotic leak occurred in the first two patients and seven other patients died in the early postoperative period from respiratory and cardiovascular complications. Four other patients developed fibrotic strictures between 6 and 24 months after their operation. The strictures were easily dilated and did not recur. The use of an EEA stapler is recommended because it reduces the operating time, the incidence of anastomotic leaks, and probably the blood loss. The majority of anastomoses can be accomplished exclusively through the left chest by using the stapler.