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A prospective randomized study comparing stapled with handsewn oesophagogastric anastomoses
S R Craig1, W S Walker, E W Cameron
1Department of Thoracic Surgery, City Hospital, Edinburgh.
Journal of the Royal College of Surgeons of Edinburgh
|February 1, 1996
Summary
For patients undergoing oesophagogastrectomy, a stapled oesophagogastric anastomosis is quicker and reduces blood loss compared to handsewn methods. This technique is safe and effective for treating oesophageal and gastric cardia carcinoma.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Gastrointestinal Surgery
Background:
- Oesophagogastrectomy is a major surgery for distal oesophageal and gastric cardia carcinoma.
- The method of oesophagogastric anastomosis (stapled vs. handsewn) can impact surgical outcomes.
Purpose of the Study:
- To compare the safety and efficacy of stapled versus handsewn oesophagogastric anastomosis.
- To evaluate operative time, blood loss, anastomotic complications, and survival rates.
Main Methods:
- Randomized controlled trial involving 100 patients with distal oesophageal or gastric cardia carcinoma.
- Patients were assigned to either a stapled or handsewn oesophagogastric anastomosis group.
- Follow-up extended to death or a minimum of 36 months.
Main Results:
- Stapled anastomosis was significantly quicker (P < 0.001) and associated with reduced operative time (P < 0.005) and blood loss (P < 0.05).
- No statistically significant differences were observed in anastomotic leaks, in-patient stay, stricture formation, or survival between the groups.
- Early post-operative mortality was 5% (5 patients).
Conclusions:
- Stapled oesophagogastric anastomosis is a safe and effective technique for oesophageal resection in patients with carcinoma.
- It offers advantages in terms of operative time and blood loss without increasing complication rates.
- Routine use in thoracic surgical practice is supported.