FAILURE OF ESOTHOPATHIC ANASTOMOSES: OUR APPROACH TO SOLVING THE PROBLEM

Summary. Introduction. Failure of esophageal anastomotic sutures is one of the severe postoperative complications. Currently, esophageal anastomoses in patients with cancer are characterized by a high failure rate of 3% to 25%. Successful formation of the anastomosis is critical to restoring continuity of the digestive tract, ensuring adequate nutrition, and reducing the risk of postoperative complications. Thus, the current state of the problem and the lack of unified approaches confirm the relevance of the study and its importance for optimizing the results of surgical treatment of patients with esophageal pathology. The aim of our work is to evaluate the effectiveness of the proposed method of forming esophageal anastomoses using the developed clamp for applying esophageal anastomoses. Materials and methods. On the basis of the State Institution «V. T. Zaitsev Institute of General and Emergency Surgery of the National Academy of Medical Sciences of Ukraine» new approach form of a clamp for the formation of esophageal anastomoses was developed (Registration number of the application No. u 2024 05547). The sample consisted of 23 patients who underwent gastrectomy for malignant tumors of the stomach in the period from 2020 to 2024. Results of the study. Intraoperatively, 3 patients of the first group had technical difficulties during the formation of the esophageal anastomosis, due to the anatomical features of the patients and reduced tissue perfusion. Among the patients of the second group, intraoperatively, in 2 cases, the above-listed complications were noted, due to the shape of the chest and previous surgical interventions. In the postoperative period, among the patients of the second group, partial failure of the esophageal-small intestine anastomosis was observed in one case. Conclusions. According to the results of the study, it should be noted the effectiveness of using the new approach we developed for forming esophageal anastomoses in comparison with the use of Fedorov’s clamp for fixing the esophageal stump during the formation of esophageal-intestinal anastomosis.