Oesophagogastrectomy using stapling instruments.

Oesophagogastrectomy is generally considered to be the treatment of choice for resectable tumours of the oesophagus. We have, since January 1980, used stapling instruments whenever possible for the resection and anastomosis. We have also, since June 1983, employed a left thoracotomy approach for lesions of the gastric cardia and mid- or lower oesophagus. One hundred and sixty four patients underwent oesophagogastrectomy during a seven year period, 75 via left thoracotomy. The overall peri-operative mortality was 7.9%. Complications occurred in 17% of patients with anastomotic leakage in 1.8% and anastomotic strictures in 9.7%. Mean hospital stay was 14 days. In the left thoracotomy sub-group mortality was 5%, the complication rate 23%, leak rate 3%, stricture rate 12% and mean hospital stay 13 days.