TY - JOUR
T1 - Impact of a long linear staplers on the incidence of stricture after triangulating esophagogastric anastomosis
AU - Toyota, Satoshi
AU - Kimura, Yasue
AU - Jogo, Tomoko
AU - Hu, Qingjiang
AU - Hokonohara, Kentaro
AU - Nakanishi, Ryota
AU - Hisamatsu, Yuichi
AU - Ando, Koji
AU - Oki, Eiji
AU - Mori, Masaki
N1 - Publisher Copyright:
© 2021 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2021/8
Y1 - 2021/8
N2 - Background: Various techniques have been reported for esophagogastric anastomosis to prevent anastomotic leakage. Recently, not only postoperative anastomotic leakage but also anastomotic stricture is considered important because stricture contributes to the patient's postoperative quality of life. However, the best procedure for anastomosis has not been established. Materials and Methods: The authors divided 101 patients with thoracic or abdominal esophageal cancer who underwent cervical triangulating esophagogastric anastomosis using a linear stapler between May 2017 and May 2020 into 2 groups: surgery with a short (45 mm) linear stapler (SS group, n = 59) or a long (60 mm) stapler (LS group, n = 42). The frequencies of anastomotic leakage and stricture were compared between the 2 groups. Results: The incidence of anastomotic leakage and stricture without leakage were significantly lower in the LS versus SS group (respectively: leakage: 15% vs. 0%, P = 0.01; stricture: 36% vs. 7%, P = 0.01). A short linear stapler and anastomotic leakage were independent risk factors for anastomotic stricture in the multivariate analysis (short stapler: odds ratio, 3.27; 95% confidence interval, 1.08-9.9; P = 0.03; anastomotic leakage: odds ratio, 2.78; 95% confidence interval, 1.02-8.5; P = 0.04). Conclusion: A long linear stapler is preferable for cervical triangulating esophagogastric anastomosis.
AB - Background: Various techniques have been reported for esophagogastric anastomosis to prevent anastomotic leakage. Recently, not only postoperative anastomotic leakage but also anastomotic stricture is considered important because stricture contributes to the patient's postoperative quality of life. However, the best procedure for anastomosis has not been established. Materials and Methods: The authors divided 101 patients with thoracic or abdominal esophageal cancer who underwent cervical triangulating esophagogastric anastomosis using a linear stapler between May 2017 and May 2020 into 2 groups: surgery with a short (45 mm) linear stapler (SS group, n = 59) or a long (60 mm) stapler (LS group, n = 42). The frequencies of anastomotic leakage and stricture were compared between the 2 groups. Results: The incidence of anastomotic leakage and stricture without leakage were significantly lower in the LS versus SS group (respectively: leakage: 15% vs. 0%, P = 0.01; stricture: 36% vs. 7%, P = 0.01). A short linear stapler and anastomotic leakage were independent risk factors for anastomotic stricture in the multivariate analysis (short stapler: odds ratio, 3.27; 95% confidence interval, 1.08-9.9; P = 0.03; anastomotic leakage: odds ratio, 2.78; 95% confidence interval, 1.02-8.5; P = 0.04). Conclusion: A long linear stapler is preferable for cervical triangulating esophagogastric anastomosis.
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U2 - 10.1097/SLE.0000000000000899
DO - 10.1097/SLE.0000000000000899
M3 - Article
C2 - 33492082
AN - SCOPUS:85102334974
VL - 31
SP - 453
EP - 456
JO - Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
JF - Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
SN - 1530-4515
IS - 4
ER -