Influence of the Stapler Size Used in Esophagojejunostomy Anastomosis: Anastomotic Leak and Strictures After Total Gastrectomy

Çakabay, Bahri; Aksel, Bülent; Ünal, Ekrem; Bayar, Sancar; Kocaoğlu, Hakan; Demirci, Salim; Akgül, Hasan

doi:10.5336/medsci.2011-24291

Cited by 4 publications

(5 citation statements)

References 10 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Twenty-one studies were included (Table 1), representing a total of 7226 patients [12,13,15,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]. Seven oesophageal, twelve gastric, and three lower GI studies were identified.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Association Between Circular Stapler Diameter and Stricture Rates Following Gastrointestinal Anastomosis: Systematic Review and Meta-analysis

et al. 2018

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 99%

“…The seven oesophageal studies encompassed 1081 patients [13,27,28,32,[35][36][37]. For the pooled oesophageal anastomosis studies, a clear increase in stricture rates was observed with the use of smaller circular stapler diameters.…”

Section: Oesophageal Anastomosismentioning

confidence: 99%

Association Between Circular Stapler Diameter and Stricture Rates Following Gastrointestinal Anastomosis: Systematic Review and Meta-analysis

et al. 2018

View full text Add to dashboard Cite

show abstract

“…22 In this meta-analysis, 5 observational studies were included. [23][24][25][26][27][28] It was concluded that the use of larger circular stapler size (28 mm versus 25 mm) was strongly associated with a reduced risk of postoperative anastomotic strictures in the upper GI tract. 22 Results from our study do not support the conclusion of aforementioned meta-analysis, as there were no differences observed in anastomotic insufficiency and postoperative anastomotic strictures between the 25 mm and the 28 mm stapled esophagogastric anastomosis.…”

Section: Discussionmentioning

confidence: 99%

The Circular Stapled Esophagogastric Anastomosis in Esophagectomy: No Differences in Anastomotic Insufficiency and Stricture Rates Between the 25 mm and 28 mm Circular Stapler

Sluis

Uzun

Berlth

et al. 2021

Journal of Gastrointestinal Surgery

View full text Add to dashboard Cite

Background For patients undergoing an Ivor Lewis esophagectomy with a circular stapled anastomosis, the optimal diameter of the used circular stapler to restore continuity is unknown. The aim of this study was to compare the 25 mm stapled versus the 28 mm stapled esophagogastric anastomosis after Ivor Lewis esophagectomy, focusing on anastomotic insufficiency and postoperative anastomotic strictures. Methods Between February 2008 and June 2019, 349 consecutive patients underwent Ivor Lewis esophagectomy with gastric conduit reconstruction and circular stapled anastomosis. Patient characteristics and postoperative results, such as anastomotic insufficiency rates, postoperative anastomotic stricture rates, time to anastomotic stricture rate, and the number of dilatations, were recorded in a prospective database and analyzed. Results In 222 patients (64%), the 25 mm circular stapler was used and in 127 patients (36%) the 28 mm circular stapler was used. There were no differences in baseline characteristics. Anastomotic insufficiency rates were comparable between the 25 mm (12%) and the 28 mm groups (11%) (p = 0.751). There were no differences between postoperative anastomotic strictures in the 25 mm (14%) and the 28 mm groups (14%) (p = 0.863). Within patients with postoperative anastomotic strictures, a median number of 2 dilatations were observed in each group (p = 0.573) without differences in the time to first diagnosis (p = 0.412). Conclusion There were no differences in anastomotic insufficiency and postoperative anastomotic stricture rates between the 25 mm and the 28 mm circular stapled esophagogastric anastomosis after Ivor Lewis esophagectomy. Both the 25 mm and 28 mm stapler can be safely used to create a circular stapled esophagogastric anastomosis to restore continuity after esophagectomy.

show abstract

“…When trying to decrease anastomotic leak rates for instance, Çakabay et al emphasized the importance of meticulous technique and suggested a protocol-driven approach. 35 Additional studies also support the concept that a surgeon’s experience with a given device is a key determinant in patient outcomes. A review of operative reports and web-based charts for colon and rectal resections at Brigham and Women’s Hospital (Boston) found that 19% of these procedures featured a technical error involving the stapling device.…”

Section: A Framework For the Study Of Device Tissue And Their Intermentioning

confidence: 90%

“…When trying to decrease anastomotic leak rates for instance, Çakabay et al emphasized the importance of meticulous technique and suggested a protocol-driven approach 35. Additional studies also support the concept that a surgeon’s experience with a given device is a key determinant in patient outcomes.…”

Section: A Framework For the Study Of Device Tissue And Their Intermentioning

confidence: 99%

Surgical stapling device–tissue interactions: what surgeons need to know to improve patient outcomes

Chekan¹,

Whelan²

2014

MDER

View full text Add to dashboard Cite

The introduction of both new surgical devices and reengineered existing devices leads to modifications in the way traditional tasks are carried out and allows for the development of new surgical techniques. Each new device has benefits and limitations in regards to tissue interactions that, if known, allow for optimal use. However, most surgeons are unaware of these attributes and, therefore, new device introduction creates a “knowledge gap” that is potentially dangerous. The goal of this review is to present a framework for the study of device– tissue interactions and to initiate the process of “filling in” the knowledge gap via the available literature. Surgical staplers, which are continually being developed, are the focus of this piece. The integrity of the staple line, which depends on adequate tissue compression, is the primary factor in creating a stable anastomosis. This review focuses on published studies that evaluated the creation of stable anastomoses in bariatric, thoracic, and colorectal procedures. Understanding how staplers interact with target tissues is key to improving patient outcomes. It is clear from this review that each tissue type presents unique challenges. The thickness of each tissue varies as do the intrinsic biomechanical properties that determine the ideal compressive force and prefiring compression time for each tissue type. The correct staple height will vary depending on these tissue-specific properties and the tissue pathology. These studies reinforce the universal theme that compression, staple height, tissue thickness, tissue compressibility, and tissue type must all be considered by the surgeon prior to choosing a stapler and cartridge. The surgeon’s experience, therefore, is a critical factor. Educational programs need to be established to inform and update surgeons on the characteristics of each stapler. It is hoped that the framework presented in this review will facilitate this process.

show abstract

Influence of the Stapler Size Used in Esophagojejunostomy Anastomosis: Anastomotic Leak and Strictures After Total Gastrectomy

Abstract: diameters and strictures following esophagectomy and total gastrectomy in 256 patients. World J Surg 2000;24(1):78-84.

Cited by 4 publications

References 10 publications

Association Between Circular Stapler Diameter and Stricture Rates Following Gastrointestinal Anastomosis: Systematic Review and Meta-analysis

Association Between Circular Stapler Diameter and Stricture Rates Following Gastrointestinal Anastomosis: Systematic Review and Meta-analysis

The Circular Stapled Esophagogastric Anastomosis in Esophagectomy: No Differences in Anastomotic Insufficiency and Stricture Rates Between the 25 mm and 28 mm Circular Stapler

Surgical stapling device–tissue interactions: what surgeons need to know to improve patient outcomes

Contact Info

Product

Resources

About

Influence of the Stapler Size Used in Esophagojejunostomy Anastomosis: Anastomotic Leak and Strictures After Total Gastrectomy

Abstract: diameters and strictures following esophagectomy and total gastrectomy in 256 patients. World J Surg 2000;24(1):78-84.

Cited by 4 publications

References 10 publications

Association Between Circular Stapler Diameter and Stricture Rates Following Gastrointestinal Anastomosis: Systematic Review and Meta-analysis

Association Between Circular Stapler Diameter and Stricture Rates Following Gastrointestinal Anastomosis: Systematic Review and Meta-analysis

The Circular Stapled Esophagogastric Anastomosis in Esophagectomy: No Differences in Anastomotic Insufficiency and Stricture Rates Between the 25 mm and 28 mm Circular Stapler

Surgical stapling device&ndash;tissue interactions: what surgeons need to know to improve patient outcomes

Contact Info

Product

Resources

About

Surgical stapling device–tissue interactions: what surgeons need to know to improve patient outcomes