Hand-Sewn Cervical Anastomosis Versus Stapled Intrathoracic Anastomosis After Esophagectomy for Middle or Lower Thoracic Esophageal Cancer: A Prospective Randomized Controlled Study

Okuyama, Manabu; Motoyama, Satoru; Suzuki, Hiroyuki; Saito, Reijiro; Maruyama, Kiyotomi; Ogawa, Jun–ichi

doi:10.1007/s00595-007-3541-5

Cited by 88 publications

(107 citation statements)

References 19 publications

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“…Our results demonstrated that the total complication rate in the new manual technique group was 7.4% and the anastomotic complication rate was zero, which was lower than that recorded in the traditional technique group and previous studies (4)(5)(6)(7)(8).…”

Section: Discussioncontrasting

confidence: 60%

“…The main anastomotic complications include leakage, stricture and infection. It was reported that, in esophagogastric anastomosis, the incidence rate of leakage and stricture was 0-21.9 and 0-25.8%, respectively, with manual suturing and 0-19.5 and 0-32.8%, respectively, with surgical stapling (4)(5)(6)(7)(8). Furthermore, the incidence of leakage was reported to be 2.6-17% in low anterior resection for rectal cancer with the double-stapling technique (9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

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Single-layer continuous suture contributes to the reduction of surgical complications in digestive tract anastomosis involving special anatomical locations

Zhang

et al. 2013

Molecular and Clinical Oncology

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Section: Discussioncontrasting

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Single-layer continuous suture contributes to the reduction of surgical complications in digestive tract anastomosis involving special anatomical locations

Zhang

et al. 2013

Molecular and Clinical Oncology

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“…In another study, hypoalbuminemia, neoplastic permeation of the anastomotic cut margin, and cervical anastomosis were associated with a higher incidence of anastomotic leakage (27). other possible risk factors include weight loss, history of taking steroids, neoadjuvant chemoradiotherapy, long operation time, multiple blood transfusions and technical factors (26)(27)(28)(29). In this study we showed that addition of splenectomy is associated with four time increase in the rate of anastomotic leakage.…”

Section: Discussionmentioning

confidence: 49%

Influence of Splenectomy on Morbidity of Esophageal Cancer Surgery

et al. 2010

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Background and Aim: during esophagectomy, splenic injury may occur due to unintentional operative trauma, caused by excessive traction on the splenic ligaments or misplacement of retractors. the role of spleen in immune system is well recognized and the addition of splenectomy to esophagectomy may increase the rate of complications. the goal of this study was to determine the influence of splenectomy on postoperative morbidity and mortality after esophageal resection for esophageal cancer.Materials and Methods: between January 2001 and april 2006, 420 cases with esophageal cancer underwent esophagectomy in a referral cancer institute. In 14 patients (3.3%) splenectomy was added because of unwanted splenic injury during operation. In-hospital morbidities and mortality and hospital stay were compared between patients with and without concomitant splenectomy.Results: although the overall complication rate in splenectomized patients was higher than other patients (43% vs. 30%), this figure was not statistically significant (p value: 0.3). cervical anastomotic leakage occurred in 35.7% of splenectomized patients in comparison to 12.2% of control group (p value: 0.01, odds ratio: 3.93, cI 95% : 1.27-12.2). there were no significant differences in cardiac and pulmonary complications, and in-hospital mortality rate between patients with and without splenectomy (p value > 0.05). splenectomy did significantly affect post operative hospital stay (19 ± 13 vs. 13 ± 7 days, p value: 0.004).Conclusions: during esophagectomy, unplanned splenectomy may increase the incidence of anastomotic leakage and hospital stay. therefore, whenever possible preservation of the spleen should be considered. an unexpected relationship between splenectomy and anastomotic leaks needs further investigation.

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“…Handling the stomach gently and preserving as many collaterals as possible is the key. We have to emphasize that we did all our cervical anastomose with hand-sewn technique, and the leakage rate was even lower than the reported rate by stapler method (16,17).…”

Section: Discussionmentioning

confidence: 99%

Expedite recovery from esophagectomy and reconstruction for esophageal squamous cell carcinoma after perioperative management protocol reinvention

et al. 2017

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Background: Surgery for esophageal cancer is invasive and challenging, and always to be followed with arduous post-operative care and recovery. This study, maybe one of the first in Asian populations, is to determine whether a reinvented protocol for perioperative management for esophageal cancer surgery which is being implemented in our department, will lead to a faster convalescence and also significantly decrease financial burdens garnered by patients during hospitalization. Results: There were 64 patients in group A, and 69 in group B. Ventilator days (P<0.001), ICU stay (P<0.001), and post-operative stay (P<0.001) were significantly shorter in group A patients. Complication rates were similar between the two groups. No hospital mortality was noted in either group. Hospital charges in group A were found to be perceptively lower, although not statistically significant (P value =0.078). Conclusions:The current protocol of perioperative care effectively ameliorated convalescence after esophagectomy and reconstruction for esophageal squamous cell carcinoma without increasing complication rate or mortality. It is also potentially more practical in future health care policies during this era of financial shortage.

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Hand-Sewn Cervical Anastomosis Versus Stapled Intrathoracic Anastomosis After Esophagectomy for Middle or Lower Thoracic Esophageal Cancer: A Prospective Randomized Controlled Study

Abstract: The two methods of anastomosis yielded similar anastomotic outcomes. Although the incidence of recurrent laryngeal nerve injury was higher after CHS, and proximal esophageal resection was longer, this had little impact on postoperative symptoms and long-term survival.

Cited by 88 publications

References 19 publications

Single-layer continuous suture contributes to the reduction of surgical complications in digestive tract anastomosis involving special anatomical locations

Single-layer continuous suture contributes to the reduction of surgical complications in digestive tract anastomosis involving special anatomical locations

Influence of Splenectomy on Morbidity of Esophageal Cancer Surgery

Expedite recovery from esophagectomy and reconstruction for esophageal squamous cell carcinoma after perioperative management protocol reinvention

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