Modified application of circular stapler to cervical esophagogastric anastomosis after esophagectomy for esophageal cancer

2009 ◽  
Vol 28 (7) ◽  
pp. 768-771
Author(s):  
Ming Yan ◽  
Yu-Hang Chen ◽  
Xian-Ben Liu ◽  
Ling-Fang Shao ◽  
Yin Li
Keyword(s):  
Esophageal Cancer ◽  
Circular Stapler ◽  
Esophagogastric Anastomosis ◽  
Cervical Esophagogastric Anastomosis

T-shaped linear-stapled cervical esophagogastric anastomosis for minimally invasive esophagectomy: a pilot study

2020 ◽  
Vol 106 (6) ◽  
pp. 506-509 ◽  
Author(s):  
Xinju Li ◽  
Zhe Wang ◽  
Guangjian Zhang ◽  
Junke Fu ◽  
Qifei Wu
Keyword(s):  
Esophageal Cancer ◽  
Pilot Study ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Operation Time ◽  
Esophagogastric Anastomosis ◽  
Anastomotic Complications ◽  
Invasive Esophagectomy ◽  
Cervical Esophagogastric Anastomosis ◽  
A Minor

Background: Minimally invasive esophagectomy (MIE) has become a good option in the surgical treatment of esophageal cancer. Cervical esophagogastric anastomoses (CEGA) are widely used during esophagectomy. However, CEGA are related with a higher incidence of anastomotic complications. In the present study, a new procedure of T-shaped linear-stapled cervical esophagogastric anastomosis was used during MIE and the short-term outcomes are presented. Methods: From May 2014 to December 2018, 32 consecutive patients with esophageal cancer who underwent total MIE followed by T-shaped linear-stapled cervical esophagogastric anastomosis were included. Postoperative outcomes were analyzed. Results: Fifteen men and 17 women were included this pilot study. The histology of all cases was squamous cell carcinoma. Mean operation time of T-shaped linear-stapled cervical esophagogastric anastomosis was 17.6 minutes. There were no early or late mortalities. A minor cervical anastomotic leakage occurred in 1 patient. No complications of anastomotic stenosis occurred in this study. Conclusion: The T-shaped linear-stapled cervical esophagogastric anastomosis is efficient, reliable, easy to perform, and associated with lower postoperative complication rate.

scholarly journals Comparison of End-to-Side Hand-Sewn and Side-to-Side Stapled Cervical Esophagogastric Anastomosis in Patients with Lower Thoracic Esophageal Cancer Undergoing Transhiatal Esophagectomy: An Iranian Retrospective Cohort Study

2020 ◽  
Author(s):  
Seyed Ziaeddin Rasihashemi ◽  
Ali Ramouz ◽  
Samad Beheshtirouy ◽  
Hassan Amini
Keyword(s):  
Esophageal Cancer ◽  
Anastomotic Leakage ◽  
Anastomotic Stricture ◽  
Anastomosis Group ◽  
Transhiatal Esophagectomy ◽  
Stapled Anastomosis ◽  
Esophagogastric Anastomosis ◽  
Thoracic Esophageal Cancer ◽  
Cervical Esophagogastric Anastomosis

Abstract Background: Controversies in terms of efficacy and postoperative advantages surround stapled esophagogastric anastomosis compared with the hand-sewn technique as a treatment for patients with esophageal cancer. The purpose of this study was to compare the clinical outcomes of hand-sewn end-to-side esophago-gastrostomy and side-to-side stapled cervical esophagogastric anastomosis after esophagectomy for the aforementioned patients.Methods: This retrospective cohort study involved examining the medical records of 433 patients who underwent transhiatal esophagectomy for esophageal cancer from March 2010 to March 2016. All the patients were operated using end-to-side hand-sewn esophago-gastrostomy and side-to-side stapled cervical esophagogastric anastomosis. 409 of the patients received a year’s worth of follow-up evaluations. All the cases were revisited in two weeks as well as in four, eight, and 12 months after surgery. The patients were assessed in terms of postoperative outcomes, including reflux symptoms, anastomotic leakage and stricture, and the need for anastomotic dilatation.Results: Hand-sewn anastomosis was carried out in 271 (62.5%) patients, whereas stapled anastomosis was performed in 162 (37.4%) patients. The mean operative times were 214.46±84.33 min and 250.55±43.31 min for the stapled and hand-sewn anastomosis groups, respectively (P = 0.028). The two groups showed no significant differences with respect to stays in intensive care units and hospitals. Postoperatively, 38 (14.67%) cases of anastomotic leakage were detected in the hand-sewn anastomosis group, with incidence being significantly higher than that in the stapled anastomosis group (8 cases or 5.33%; P = 0.002). Anastomotic stricture occurred less frequently in the patients who underwent stapled anastomosis (P = 0.004). Within the one-year follow-up period, the patients treated via hand-sewn anastomosis more frequently required anastomotic dilatation (P = 0.02).Conclusion: Side-to-side stapled cervical esophagogastric anastomosis may reduce operation times and decrease the rates of anastomotic leakage, anastomotic stricture, and anastomotic dilatation in patients with lower thoracic esophageal cancer undergoing transhiatal esophagectomy.

PS01.199: A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL OF CIRCULAR STAPLING VERSUS TRIANGULATING STAPLING ESOPHAGOGASTRIC ANASTOMOSIS FOR ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 106-106
Author(s):  
Masahiro Katsuda ◽  
Keiji Hayata ◽  
Mikihito Nakamori ◽  
Masaki Nakamura ◽  
Toshiyasu Ojima ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Esophageal Cancer ◽  
Anastomotic Leakage ◽  
Conflicts Of Interest ◽  
Anastomotic Stricture ◽  
Controlled Trial ◽  
University Hospital ◽  
Esophagogastric Anastomosis ◽  
Randomized Controlled ◽  
Cervical Esophagogastric Anastomosis

Abstract Background Several studies have reported that the triangulating stapling method decreases the incidence of anastomotic stricture after esophagectomy, but no randomized, controlled trial has confirmed the efficacy of the triangulating stapling method for cervical esophagogastrostomy. We compared triangulating stapling and circular stapling for cervical esophagogastric anastomosis regarding the decrease in anastomotic stricture after esophagectomy for thoracic esophageal cancer. Methods Between August 2010 and April 2014, 100 patients enrolled in this randomized, controlled trial at the Wakayama Medical University Hospital were allocated randomly to either the circular stapling group (n = 49) or the triangulating stapling group (n = 51). The primary end point was the incidence of anastomotic stricture within 12 months postoperatively. This randomized, controlled trial was registered with the University Hospital Medical Information Network Clinical Trial Registry (UMIN000004848). Results There were no differences between the circular stapling and triangulating stapling groups in terms of clinical data. The amount of time required for esophagogastric anastomosis was slightly greater for the triangulating stapling group (22 minutes) than for the circular stapling group (18 minutes) (P = .028). Anastomotic stricture occurred in 8 patients (17%) in the circular stapling group and 9 patients (19%) in the triangulating stapling group (P = .935). The rate of anastomotic leakage was 11% for the circular stapling group and 2% for the triangulating stapling group (P = .073). Conclusion This RCT compared 2 techniques of cervical esophagogastric anastomosis after esophagectomy for esophageal cancer. This study is the first to compare these 2 methods in a randomized, controlled fashion.This study could not show that the triangulating stapling method was superior to the circular stapling method for cervical esophagogastrostomy to reduce anastomotic stricture. The triangulating stapling method, however, might have the potential to decrease the rate of anastomotic leakage; a large-scale RCT will be required to assess this question. Disclosure All authors have declared no conflicts of interest.

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