Comparison of Hand-Sewn and Stapled Esophagogastric Anastomosis After Esophageal Resection for Cancer

Law, Simon; Fok, Manson; Chu, Kent‐Man; Wong, John W.

doi:10.1097/00000658-199708000-00008

Cited by 209 publications

(193 citation statements)

References 12 publications

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“…Outcomes on the Effectiveness Anastomotic Leakages Nine trials [16,17,25,[31][32][33][34][35][36] reported on anastomotic leakages (p het =0.10, I 2 =40 %); the fixed model was used, and the available data showed that there was no difference in the incidence of anastomotic leakages (RR=1.30, 95 % CI 0.87-1.92, p =0.20). It meant that both HS and CS were equivalent in preventing the leakages.…”

Section: The Results Of Meta-analysismentioning

confidence: 99%

“…Of which, 55 records were selected through reading their titles and abstracts. After checking the full text in detail, nine RCTs [16,17,25,[31][32][33][34][35][36] were identified ultimately which involved 870 patients. Figure 1 shows PRISMA statement of search flows in detail.…”

Section: Selected Studiesmentioning

confidence: 99%

“…Of these nine RCTs [16,17,25,[31][32][33][34][35][36], six papers [16,17,25,[32][33][34] were conducted in English, one [31] in French, and Studies included in qualitative synthesis (n = 9)…”

Section: Baseline Characteristics and Risk Of Bias Of Included Studiesmentioning

confidence: 99%

“…Anastomotic Stricture Eight trials [16,17,25,31,[33][34][35][36] reported on anastomotic stricture (p het =0.008, I 2 =63 %); the random model was conducted. It had no benefit in the incidence of anastomotic stricture between the two groups (RR=0.97, 95 % CI 0.47-1.99, p =0.93).…”

Section: Outcomes On the Securitymentioning

confidence: 99%

“…Disagreement still exists, and they often focus on the technical modality of anastomosis, such as the hand-sewn or stapled methods [13,14]. Compared with the hand-sewn (HS) method, the results from published randomized controlled trials (RCTs) showed that CS was considered to reduce the incidence of operative complications [15,16], but with a higher chance of anastomotic stricture [17,18].…”

Section: Introductionmentioning

confidence: 99%

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Hand-Sewn Versus Stapled Esophagogastric Anastomosis in the Neck: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Wang

Shi

et al. 2013

Indian J Surg

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The application of cervical esophagogastric anastomoses was of great concern. However, between circular stapler (CS) and hand-sewn (HS) methods with anastomosis in the neck, which one has better postoperative effects still puzzles surgeons. This study aims to systematically evaluate the effectiveness, security, practicality, and applicability of CS compared with the HS method for the esophagogastric anastomosis after esophageal resection. A systematic literature search, as well as other additional resources, was performed which was completed in January 2013. The relevant randomized controlled trials (RCTs) about the surgical technique for esophageal resection were included. Trial data was reviewed and extracted independently by two reviewers. The quality of the included studies was assessed by the recommended standards basing on Cochrane handbook 5.1.0, and the data was analyzed via RevMan 5 software (version 5.2.0). Nine studies with 870 patients were included. The results showed that in comparing HS to CS methods with cervical anastomosis, no significant differences were found in the risk of developing anastomotic leakages (relative risk (RR)=1.30, 95 % confidence intervals (CI) 0.87-1.92, p =0.20), as well as the anastomosis stricture (RR=0.97, 95 % CI 0.47-1.99, p =0.93), postoperative mortality (RR = 0.83, 95 % CI 0.43-1.58, p =0.57), blood loss (mean difference (MD)=39.68; 95 % CI −6.97, 86.33; p =0.10) and operative time (MD=18.05; 95 % CI −3.22, 39.33; p =0.10). However, the results also illustrated that the CS methods with cervical anastomosis might be less time-consuming and have shorter hospital stay and higher costs. Based upon this meta-analysis, there were no differences in the postoperative outcomes between HS and CS techniques. And the ideal technique of cervical esophagogastric anastomosis following esophagectomy remains under controversy.

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