OBJECTIVE: To compare anastomotic complications of stapled versus hand-sewn cervical esophago-gastric anastomosis. METHODS: All patients undergoing esophageal resection are entered into a prospectively maintained database. The database was queried to identify patients who had near total esophagectomy with cervical esophago-gastric anastomosis. The effect of anastomotic technique and surgeon experience on anastomotic complications, leak, and stricture were analyzed. RESULTS: Eighty-one patients underwent open or minimally invasive esophagectomy and gastric pull-up with or without thoracic mobilization. Eighteen patients had hand-sewn anastomosis and 63 had a partially stapled anastomosis. There was no significant difference between leak rate (22% (4/18) versus 7% (5/63) P = 0.09) and anastomotic stricture rate (38% (7/18) versus 26% (17/63), P = 0.34) between the two groups. Dividing the experience chronologically into three groups of 27 reveals a trend towards decreased leak rate with experience. The leak rate was only 3.7 % (1/27) in the most recent group compared with 14.8% (4/27) in the first group (P = 0.17). CONCLUSIONS: In our experience, there was no significant difference in anastomotic complications between hand-sewn and stapled anastomosis. However, there is a decreasing trend in anastomotic complications with increasing surgeon experience. Copyright (c) 2010 Elsevier Inc. All rights reserved.
OBJECTIVE: To compare anastomotic complications of stapled versus hand-sewn cervical esophago-gastric anastomosis. METHODS: All patients undergoing esophageal resection are entered into a prospectively maintained database. The database was queried to identify patients who had near total esophagectomy with cervical esophago-gastric anastomosis. The effect of anastomotic technique and surgeon experience on anastomotic complications, leak, and stricture were analyzed. RESULTS: Eighty-one patients underwent open or minimally invasive esophagectomy and gastric pull-up with or without thoracic mobilization. Eighteen patients had hand-sewn anastomosis and 63 had a partially stapled anastomosis. There was no significant difference between leak rate (22% (4/18) versus 7% (5/63) P = 0.09) and anastomotic stricture rate (38% (7/18) versus 26% (17/63), P = 0.34) between the two groups. Dividing the experience chronologically into three groups of 27 reveals a trend towards decreased leak rate with experience. The leak rate was only 3.7 % (1/27) in the most recent group compared with 14.8% (4/27) in the first group (P = 0.17). CONCLUSIONS: In our experience, there was no significant difference in anastomotic complications between hand-sewn and stapled anastomosis. However, there is a decreasing trend in anastomotic complications with increasing surgeon experience. Copyright (c) 2010 Elsevier Inc. All rights reserved.
Authors: Miklosh Bala; Fausto Catena; Jeffry Kashuk; Belinda De Simone; Carlos Augusto Gomes; Dieter Weber; Massimo Sartelli; Federico Coccolini; Yoram Kluger; Fikri M Abu-Zidan; Edoardo Picetti; Luca Ansaloni; Goran Augustin; Walter L Biffl; Marco Ceresoli; Osvaldo Chiara; Massimo Chiarugi; Raul Coimbra; Yunfeng Cui; Dimitris Damaskos; Salomone Di Saverio; Joseph M Galante; Vladimir Khokha; Andrew W Kirkpatrick; Kenji Inaba; Ari Leppäniemi; Andrey Litvin; Andrew B Peitzman; Vishal G Shelat; Michael Sugrue; Matti Tolonen; Sandro Rizoli; Ibrahima Sall; Solomon G Beka; Isidoro Di Carlo; Richard Ten Broek; Chirika Mircea; Giovanni Tebala; Michele Pisano; Harry van Goor; Ronald V Maier; Hans Jeekel; Ian Civil; Andreas Hecker; Edward Tan; Kjetil Soreide; Matthew J Lee; Imtiaz Wani; Luigi Bonavina; Mark A Malangoni; Kaoru Koike; George C Velmahos; Gustavo P Fraga; Andreas Fette; Nicola de'Angelis; Zsolt J Balogh; Thomas M Scalea; Gabriele Sganga; Michael D Kelly; Jim Khan; Philip F Stahel; Ernest E Moore Journal: World J Emerg Surg Date: 2022-10-19 Impact factor: 8.165