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<p>Cervical anastomosis following subtotal esophagectomy (McKeown esophagectomy) is a standard reconstruction technique in Japan; however, it remains challenging because of its high anastomotic leakage rate. We herein report a simplified, time-saving, and reproducible method for performing McKeown esophagectomy. In the supine position, the stomach roll is elevated toward the anastomotic site through either the retrosternal or retromediastinal routes. After transecting the esophagus, nine single-layer interrupted sutures were made using the in-out and out-in technique for the posterior wall. In-out and out-in sutures were placed on both sides of the anterior wall to ensure inversion of the mucosal layer of the stomach roll. The last three stitches were placed using the out-in and in-out stitch techniques to close the central side of the anterior wall. This simplified single-layer interrupted suture technique does not require complex maneuvers and enables surgeons to perform it easily, even within a narrow working space, after McKeown esophagectomy.</p>

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Simplified single-layer interrupted hand-sewn esophagogastric anastomosis for McKeown esophagectomy: A simple and reproducible technique

  • 期刊论文

  • 发表日期：

    2026年2月2日

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  • Sho Sato,
  • Tsutomu Sato,
  • Hayato Watanabe,
  • Yukio Maezawa,
  • Takashi Kosaka,
  • Hirotoshi Akiyama,
  • Itrau Endo

摘要

Cervical anastomosis following subtotal esophagectomy (McKeown esophagectomy) is a standard reconstruction technique in Japan; however, it remains challenging because of its high anastomotic leakage rate. We herein report a simplified, time-saving, and reproducible method for performing McKeown esophagectomy. In the supine position, the stomach roll is elevated toward the anastomotic site through either the retrosternal or retromediastinal routes. After transecting the esophagus, nine single-layer interrupted sutures were made using the in-out and out-in technique for the posterior wall. In-out and out-in sutures were placed on both sides of the anterior wall to ensure inversion of the mucosal layer of the stomach roll. The last three stitches were placed using the out-in and in-out stitch techniques to close the central side of the anterior wall. This simplified single-layer interrupted suture technique does not require complex maneuvers and enables surgeons to perform it easily, even within a narrow working space, after McKeown esophagectomy.