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Updated: Sep 4, 2026
An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
Linear versus circular stapler for colorectal anastomosis in laparoscopic sigmoidectomy: a retrospective comparative
Hiep Van Pham1, Thang Manh Tran2, Phuong Nguyen Nhu Pham2
1Department of Digestive Surgery, 108 Military Central Hospital, Hanoi, Vietnam.
Purpose:
The choice between linear side-to-side and circular end-to-end staplers for colorectal anastomosis after laparoscopic sigmoidectomy remains a topic of debate. This study compared intraoperative efficiency, postoperative recovery, complications, and quality of life (QoL) between the 2 techniques.
Methods:
This retrospective cohort study included 83 patients who underwent elective laparoscopic sigmoidectomy for sigmoid cancer at a single center between January 2023 and August 2024. Patients were grouped according to the stapling technique used for anastomosis (linear stapler, n=23; circular stapler, n=60). Intraoperative characteristics, including operative time and stapler use; postoperative outcomes, including length of hospital stay and complications; and longitudinal QoL, assessed using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Colorectal Cancer (QLQ-CR29) questionnaire at 1, 3, 6, 9, and 12 months, were analyzed.
Results:
Baseline characteristics were comparable between groups. Operative time did not differ significantly between the linear and circular stapler groups (90.73±14.02 minutes vs. 94.63±13.65 minutes, P=0.25). The linear stapler group required more staplers overall (3.04±0.82 vs. 1.53±0.72, P<0.001) but had a shorter hospital stay (10.09±1.83 days vs. 11.70±3.62 days, P=0.04). Oncologic outcomes and complication rates were low and comparable (anastomotic leakage: 4.3% vs. 0%, P=0.277). At 12 months, QoL scores did not differ significantly between groups, although descriptive trends suggested faster recovery of bowel function and abdominal pain in the linear stapler group during the first 6 months.
Conclusion:
In this single-center retrospective series, both linear side-to-side and circular end-to-end stapling techniques appeared safe, feasible, and clinically acceptable. Circular stapling required fewer stapling devices intraoperatively, whereas linear stapling was associated with modestly shorter hospitalization and descriptively faster early functional recovery. These findings are hypothesis-generating and warrant prospective validation in larger, balanced cohorts to guide patient- and technique-specific surgical decision-making.
