Prevention of anastomotic stricture with a purse-string suture technique on the gastric side during esophageal carcinoma operations: Retrospective study of 463 consecutive cases

Background The objective of this study was to investigate the effect of a gastric side purse-string technique on anastomotic strictures during esophageal carcinoma operations. Methods From 1996 to 2005, esophageal carcinoma operations were performed on 1128 consecutive patients. Among them, 463 underwent esophagogastric anastomosis with purse-string sutures on the gastric side (purse group) and the other 665 did not (nonpurse group). Anastomotic strictures, reflux, and leakage were analyzed and compared between the two groups after the operations. Results Complete follow-up was conducted on all 1128 patients within 6 months after the operation. In contrast to the nonpurse group with a postoperative anastomotic stricture rate of 5.4% (36/665), the purse group demonstrated a significantly lower rate (0.2%, 1/463). The occurrence rates of anastomotic leakage in the nonpurse and purse groups were 0.9% (6/665) and 0.4% (2/463), respectively. Of the 17 cases of gastroesophageal reflux, 15 (15/665, 1.8%) were found in the nonpurse group and 2 (2/463, 1.1%) in the purse group. Conclusions Thus, a purse-string suture technique on the gastric side might be an effective method for preventing the occurrence of anastomotic strictures after esophageal resection.