Experience with the EEA stapling device.

The EEA stapling instrument was used to perform 48 anastomoses without operative mortality. One of the 29 colorectal anastomoses developed a leak. Two intraabdominal abscesses were noted, one after an intraperitoneal colocolostomy and one after a colorectal anastomosis. No leaks were demonstrated in the 12 esophageal anastomoses. Minor bleeding that occurred in one of the colorectal anastomoses ceased spontaneously without need for transfusion. One esophageal and one colorectal anastomosis became narrowed postoperatively, but both were corrected with dilatation without further problem. In two of the very low colorectal anastomoses, transient fecal soilage occurred for 4 to 5 months postoperatively. On the basis of our experience, we believe that the EEA instruments has a definite place in gastrointestinal surgery. Its greatest virtue is that it provides a means to perform the heretofore technically difficult and frequently insecure colorectal and esophageal anastomoses with greater facility and security.