Esophagojejunostomy after total gastrectomy: A systematic review and meta‐analysis comparing hand‐sewn and stapled anastomosis

Honório, Fernanda Cavalcanti Cabral; Tustumi, Francisco; Filho, João Emílio Lemos Pinheiro; Marques, Stefanie Sophie Buuck; Glina, Felipe Placco Araújo; Henriques, Alexandre Cruz; Dias, André Roncon; Waisberg, Jaques

doi:10.1002/jso.26909

Cited by 4 publications

(8 citation statements)

References 34 publications

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“…Overall complications rate in our study was 18.1%, with no significant difference between the analyzed groups (21% for hand-sewn; 16% for stapler group; P=0.50), same as reported in a recent meta-analysis [6]. The work of Watanabe, et al from Japan on over 20 000 patients reported overall morbidity at 26.2%, which is similar to our study [37].…”

Section: Discussionsupporting

confidence: 90%

“…There was no significant difference in hospital mortality between the hand-sewn and stapled anastomosis groups in our study (P=0.837). A meta-analysis on esophagogastric anastomosis by Markar et al, as well as recent meta-analysis on esophago-jejunal anastomosis, confirmed these results [6,50]. Two large-cohort studies performed using the National Cancer Databases reported in-hospital mortality (2.2%), 30-day mortality (0.9-4.7%), and 90-day mortality (9.1%) [37,51].…”

Section: Discussionmentioning

confidence: 82%

“…However, there are conflicting reports on this issue. A recent meta-analysis [ 6 ] revealed that duration of the surgery was 22 minutes shorter for stapling anastomosis than for hand-sewn EJA, but without further impact on the morbidity and mortality after surgery. However, the analysis included data from studies comparing different surgical techniques linear and circular stapling and laparoscopic and open gastrectomy.…”

Section: Discussionmentioning

confidence: 99%

“…EJA may be performed using traditional hand-sewn technique or mechanical stapling, using linear or circular devices [1]. Although stapled anastomosis is a well-described and commonly used method, there is little recent data regarding the surgical complications of open total gastrectomy with comparison of stapled and hand-sewn esophago-jejunal anastomosis [6]. Some previous studies found a reduction in duration of the surgery, along with lower incidence of anastomotic leakage and higher rate of strictures in the stapler group, while others reported no difference between these 2 techniques [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…Some previous studies found a reduction in duration of the surgery, along with lower incidence of anastomotic leakage and higher rate of strictures in the stapler group, while others reported no difference between these 2 techniques [7][8][9][10]. A recent meta-analysis showed that hand-sewn and stapled anastomosis have similar surgical outcomes, while staplers reduce the operative time [6], but the recent data about open TG are limited. Only 12 studies were included in the meta-analysis, with 1 recent study on open TG comprising 63 patients [11].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Comparison of Postoperative Outcomes of Hand-Sewn Versus Stapled Esophago-jejunal Anastomosis During Total Gastrectomy for Gastric Cancer in 72 Patients: A Retrospective, Single-Center Study in Poland

et al. 2023

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Background:Mechanical stapling is a commonly used alternative to hand-sewn technique for esophago-jejunal anastomosis in total gastrectomy (TG). Some studies report reduction in postoperative complications in the stapler group. This retrospective study aimed to compare short-and long-term surgical outcomes between the groups with stapled and hand-sewn esophago-jejunal anastomosis (EJA) during open TG for gastric cancer. Material/Methods:The study included 72 adult patients with gastric cancer who underwent TG in the Department of Digestive Tract Surgery in Katowice between May 2018 and December 2021. The patients were divided into 2 groups according to the technique of EJA: stapled (44 cases) or hand-sewn (28 cases). We compared the groups in terms of the duration of the surgery, length of hospital stay, and occurrence of complications (focusing on anastomotic leakage, stricture and abdominal abscess). Results:There were no significant differences in duration of the surgery (P=0.6), blood loss (P=0.7), or length of postoperative hospital stay (P=0.2) among the groups. Early postoperative complications rates were 9.1% (4/44) in the stapler group and 17.9% (5/28) in the hand-sewn group (P=0.27). The most frequent complication was anastomotic leakage, with 2 cases in each group (P=0.76). The mean follow-up time was 1.8±0.9 (0.3-3.6) years. During this period the anastomotic stricture occurred in 7 (15.9%) cases with stapled anastomosis and in 5 (17.9%) cases with hand-sewn anastomosis (P=0.52). Conclusions:In this study there were no significant differences in mortality, morbidity, and surgery duration between stapled and hand-sewn esophago-jejunal anastomosis in total gastrectomy.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Comparison of Postoperative Outcomes of Hand-Sewn Versus Stapled Esophago-jejunal Anastomosis During Total Gastrectomy for Gastric Cancer in 72 Patients: A Retrospective, Single-Center Study in Poland

et al. 2023

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The safety and feasibility assessment of overlap esophagojejunostomy with self-pulling and latter transection technique in totally laparoscopic total gastrectomy

Wang,

Liu,

Cui

et al. 2024

Journal of Gastrointestinal Surgery

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Application of hand-sewn esophagojejunostomy in laparoscopic total gastrectomy

Gu,

Li,

Zhou

2024

World J Surg Onc

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Objective To investigate the clinical efficacy and prognostic implication of hand-sewn anastomosis in laparoscopic total gastrectomy (LTG). Methods Retrospective analysis is adopted to the clinicopathologic data of 112 patients with gastric cancer (GC) who went through LTG in the Department of General Surgery, the Second Affiliated Hospital of Anhui Medical University between October 2020 and October 2022. Among them, 60 individuals receiving medical care were split into the hand-sewn anastomosis group (Group H, N = 60); while, 52 individuals were split into the circular stapler anastomosis group (Group C, N = 52) The clinical efficacy and prognostic conditions of hand-sewn anastomosis are compared with those of circular stapler anastomosis in the application of LTG. Results The analysis results indicated that no notable difference was observed in intraoperative bleeding volume, time to first flatus (TFF), postoperative hospitalization duration and postoperative complications among the two groups (P > 0.05). Group H had shorter esophagojejunal anastomosis duration (20.0 min vs. 35.0 min) and surgery duration (252.6 ± 19.4 min vs. 265.9 ± 19.8 min), smaller incisions (5.0 cm vs. 10.5 cm), and lower hospitalization costs (58415.0 CNY vs. 63382.5 CNY) compared to Group C (P < 0.05). Conclusion The clinical efficacy and the postoperative complications of hand-sewn esophagojejunostomy are basically equivalent in comparison to the circular stapler anastomosis in the application of LTG. Its advantage lies in shorter esophagojejunal anastomosis duration, shorter surgery duration, smaller incisions, lower hospitalization costs and wider adaptability of the location of the tumor.

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Esophagojejunostomy after total gastrectomy: A systematic review and meta‐analysis comparing hand‐sewn and stapled anastomosis

Cited by 4 publications

References 34 publications

Comparison of Postoperative Outcomes of Hand-Sewn Versus Stapled Esophago-jejunal Anastomosis During Total Gastrectomy for Gastric Cancer in 72 Patients: A Retrospective, Single-Center Study in Poland

Comparison of Postoperative Outcomes of Hand-Sewn Versus Stapled Esophago-jejunal Anastomosis During Total Gastrectomy for Gastric Cancer in 72 Patients: A Retrospective, Single-Center Study in Poland

The safety and feasibility assessment of overlap esophagojejunostomy with self-pulling and latter transection technique in totally laparoscopic total gastrectomy

Application of hand-sewn esophagojejunostomy in laparoscopic total gastrectomy

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