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Related Experiment Videos

Experience with the EEA stapler for esophagojejunostomy.

H Habu1, F Kando, N Saito

  • 1First Department of Surgery, Tokyo Medical and Dental University, School of Medicine, Japan.

International Surgery
|April 1, 1989
PubMed
Summary

The EEA stapler simplifies esophagojejunostomy after total gastrectomy for gastric cancer. Stapled anastomosis is as reliable as hand sutures, with reduced operating time and no operative deaths.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Surgical Technology

Background:

  • Total gastrectomy is a standard procedure for gastric cancer.
  • Esophagojejunostomy is a critical reconstructive step following total gastrectomy.
  • Surgical techniques for esophagojejunostomy aim to minimize complications and improve patient outcomes.

Purpose of the Study:

  • To compare the efficacy and safety of EEA stapler versus hand sutures for esophagojejunostomy after total gastrectomy.
  • To evaluate operative time, anastomotic leakage rates, and early postoperative mortality between the two techniques.

Main Methods:

  • A retrospective analysis of 239 patients undergoing total gastrectomy for gastric cancer between 1979 and 1986.
  • Patients were divided into two groups: EEA stapler esophagojejunostomy (94 patients) and hand-sutured esophagojejunostomy (145 patients).

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  • Comparison of operating time, resected esophageal length, leakage rates, and 30-day mortality.

    • Main Results:

    • The stapled group had a significantly shorter operating time (288 +/- 60 min vs. 306 +/- 75 min, p < 0.05) and a longer resected esophageal length (19 +/- 17 mm vs. 14 +/- 14 mm, p < 0.01).
    • Anastomotic leakage rates were comparable between the stapled (7.4%) and sutured (13.8%) groups (no significant difference).
    • No operative deaths occurred in the stapled group, while five patients (3.4%) died within 30 days in the sutured group, two due to anastomotic leakage.

    Conclusions:

    • The EEA stapler offers a simpler and more facilitated approach to esophagojejunostomy following total gastrectomy.
    • Stapler-assisted anastomosis is a reliable alternative to hand sutures, demonstrating comparable safety with potential benefits in operative efficiency and reduced mortality.