Linear Stapled Esophagogastrostomy is More Effective Than Hand-sewn or Circular Stapler in Prevention of Anastomotic Stricture: a Comparative Clinical Study

Overview

Journal J Gastrointest Surg

Specialty Gastroenterology

Date 2011 Apr 13

PMID 21484495

Citations 30

Authors

Qi-Rong Xu

Kang-Ning Wang

Wen-Ping Wang

Kun Zhang

Long-Qi Chen

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this study was to retrospectively compare the operative effects of linear stapled intrathoracic esophagogastrostomy with hand-sewn or circular stapled anastomosis in prevention of anastomotic stricture.

Method: Between October 2007 and October 2009, 293 patients with esophageal or gastric cardia cancer underwent a curative intent resection. Patients received either a linear stapled (LS group, n = 166), conventional hand-sewn (HS group, n = 59), or circular stapled intrathoracic esophagogastric anastomosis (CS group, n = 68). The patients were followed-up and compared at 3 months after the operation.

Result: Three groups of patients were comparable on clinical baseline characteristics. There was one operative death in the HS group. The operative complications were documented in 15 patients (5.1%), with no difference among three groups (χ(2) = 2.215, P = 0.330). The follow-up rate was 96.9%. The anastomotic diameter was 1.6 ± 0.4 cm in the LS group, 1.2 ± 0.3 cm in the HS group, and 1.0 ± 0.4 cm in the CS group, respectively (F = 58.110, P < 0.001). The anastomotic stricture rates were 1.9% (3/162) in the LS group, 9.3% (5/54) in the HS group, and 20.9% (14/67) in the CS group, respectively (χ(2) = 24.095, P < 0.001). The reflux score in LS group was lower than other two groups (H = 6.995, P = 0.030).

Conclusion: The linear stapled esophagogastrostomy could decrease anastomotic stricture without increasing gastroesophageal reflux.

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