Technique of minimally invasive Ivor Lewis esophagogastrectomy with intrathoracic stapled side-to-side anastomosis.

Objective: An intrathoracic linear stapled side-to-side anastomosis for gastroesophageal junction malignancy is feasible, results in low leak rates and less stenosis.
Design: Retrospective case series.
Setting: University tertiary care center.
Patients: Between March 2008 and January 2009, six patients with gastroesophageal junction malignancy undergoing minimally invasive esophagectomy with an intrathoracic linear stapled side-to-side anastomosis were identified and their clinicopathological data analyzed.
Main Outcome Measures: Technique of a 6-cm side-to-side stapled intrathoracic esophagogastric anastomosis.
Results: Six patients underwent a minimally invasive esophagectomy with a side-to-side stapled intrathoracic esophagogastric anastomosis. Median age was 61.5 years. All patients had gastroesophageal junction adenocarcinoma and completed neoadjuvant chemoradiation therapy. The median operative time was 360 min. No patient received a blood transfusion. The 30-day mortality was 0. The median length of hospital stay was 8 days. The median number of nodes harvested was 18. At a median follow-up of 9 months, all patients were alive. There have been no anastomotic strictures to date.
Conclusion: A 6-cm side-to-side stapled intrathoracic esophagogastric anastomosis is feasible and is associated with a low anastomotic leak rate.