Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2019 Oct;43(10):2483-2489.
doi: 10.1007/s00268-019-05057-0.

Comparison of Outcomes with Semi-mechanical and Circular Stapled Intrathoracic Esophagogastric Anastomosis following Esophagectomy

Fady Yanni #  1 , Pritam Singh #  2 , Nilanjana Tewari  2 , Simon L Parsons  2   3 , James A Catton  2 , John Duffy  2 , Neil T Welch  2 , Ravinder S Vohra  2   3
Affiliations
Comparative Study

Comparison of Outcomes with Semi-mechanical and Circular Stapled Intrathoracic Esophagogastric Anastomosis following Esophagectomy

Fady Yanni et al. World J Surg. 2019 Oct.

Abstract

Background: Several techniques have been described for esophagogastric anastomosis following esophagectomy. This study compared the outcomes of circular stapled anastomoses with semi-mechanical technique using a linear stapler.

Methods: Perioperative data were extracted from a contemporaneously collected database of all consecutive esophagectomies for cancer with intrathoracic anastomoses performed in the Trent Oesophago-Gastric Unit between January 2015 and April 2018. Anastomotic techniques: circular stapled versus semi-mechanical, were evaluated and outcomes were compared. The primary outcome was anastomotic leak rate. Secondary outcomes included anastomotic stricture, overall complication rates, length of stay (LOS) and 30 day all-cause mortality.

Results: One hundred and fifty-nine consecutive esophagectomies with intrathoracic anastomosis were performed during the study period. There were no significant differences between the two groups in terms of age, American Society of Anaesthesiologists score, Charlson comorbidity index and neoadjuvant therapies received. Circular stapled anastomoses were performed in 85 patients, while 74 patients received a semi-mechanical anastomosis. Clavien-Dindo complications II or more were higher in the circular stapled group (p = 0.02). There were 16 (10%) anastomotic leaks overall, three (4%) in semi-mechanical group versus 13 (15%) in the circular stapled group (p < 0.019). There was no statistically significant difference between the two groups in terms of LOS, 30-day mortality or the need for endoscopic dilatation of the anastomosis at 3 months follow-up.

Conclusion: The move from a circular stapled to a semi-mechanical intrathoracic anastomosis has been associated with a reduced postoperative anastomotic leak rate following esophagectomy for esophageal cancer.

PubMed Disclaimer

Comment in

References

    1. Dent B et al (2016) Management and outcomes of anastomotic leaks after oesophagectomy. Br J Surg 103(8):1033–1038 - DOI
    1. Low DE et al (2019) Benchmarking complications associated with esophagectomy. Ann Surg 269(2):291–298 - DOI
    1. Goense L et al (2019) Impact of postoperative complications on outcomes after oesophagectomy for cancer. Br J Surg 106(1):111–119 - DOI
    1. Booka E et al (2015) The impact of postoperative complications on survivals after esophagectomy for esophageal cancer. Medicine 94(33):e1369 - DOI
    1. Markar SR, Karthikesalingam A, Low DE (2015) Enhanced recovery pathways lead to an improvement in postoperative outcomes following esophagectomy: systematic review and pooled analysis. Dis Esophagus 28(5):468–475 - DOI

Publication types