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J Thorac Cardiovasc Surg 2007;133:581-582
© 2007 The American Association for Thoracic Surgery

Brief Communication

Inkwelling increases benign stricture formation after Ivor Lewis esophagogastrectomy

Department of Cardiothoracic Surgery, Derriford Hospital, Plymouth NHS Trust, Plymouth, Devon, United Kingdom.

Received for publication August 12, 2006; accepted for publication September 28, 2006.

^_* Address for reprints: Enoch Akowuah, MD, MRCS, Department of Cardiothoracic Surgery, Derriford Hospital, Plymouth NHS Trust, Plymouth Devon, PL6 8DH, United Kingdom. (Email: akowuah@yahoo.com).

The first 20% of the full text of this article appears below.

Inkwelling (reinforcement of the gastroesophageal anastomosis) may reduce anastomotic leak rates after Ivor Lewis esophagogastrectomy. The technique was first described by Procter¹ in 1967 and is routinely used by surgeons.

However, as our understanding of the causes of anastomotic dehiscence has improved, for example, the role of preoperative and postoperative nutritional status, and new surgical techniques have developed, principally the use of stapling devices, the usefulness of the inkwelling procedure in reducing anastomotic leak is debatable. A possible drawback of inkwelling is that it may lead to a narrowing of the gastroesophageal anastomotic site and therefore potentially increase the incidence of benign esophageal strictures. We routinely performed inkwelling of the gastroesophageal anastomotic site in our practice. However, after a review of our data suggested that inkwelling did not affect the rate of anastomotic dehiscence, the technique was abandoned.² In this study, we compared the rates of benign esophageal stricture in patients having . . . [Full Text of this Article]