THE APPLICATION OF STAPLERS IN THE UPPER GASTROINTESTINAL-TRACT

Mechanic or stapled anastomoses of hollow organs represent a safe and attractive alternative to the manual suture. The rate of complications for the duodenal stump closure by linear staplers is minimal with leakages below 1%; the same is true for the jejunum. In esophagogastrostomies which are often performed cervically, the stapler offers more safety compared to manual sutures, but the rate of stenoses is higher with about 15%. Stenoses have been observed especially with smaller magazines (25 mm diameter). For esophagojejunostomies safety is much greater with mechanic staplers than with manual sutures. Only most experienced surgeons would achieve the same results with the same low rate of leakages of less than 10%; stenoses do not have clinical relevance.