Comparison of manual and mechanical cervical esophagogastric anastomosis after esophageal resection for squamous cell carcinoma: A prospective randomized controlled trial
Journal
European Journal of Cardio-thoracic Surgery
Journal Volume
25
Journal Issue
6
Pages
1097-1101
Date Issued
2004
Author(s)
Abstract
Objective: The use of a circular stapler in cervical esophagogastric anastomosis remains controversial. This study was to compare the postoperative and long-term results of manual and mechanical techniques for cervical esophagogastric anastomosis after resection for squamous cell carcinoma. Methods: A prospective randomized controlled trial was undertaken in 63 patients with curatively resectable squamous cell cancer of the thoracic esophagus between 1996 and 1999. Patients were randomized to receive either a hand-sewn (32 patients) or circular stapled (31 patients) cervical esophagogastric anastomosis. Results: The mean operating time was longer when the hand-sewn method was used (524 vs. 447 min, P<0.001). Anastomotic leakage was noted in seven patients (22%) in the hand-sewn group and eight patients (26%) in the stapler group (P=NS). Hospital mortality occurred in four patients (13%) of the hand-sewn group and in three patients (10%) of the stapler group (P=NS). After the operation, four patients (14%) in the hand-sewn group and five patients (18%) in the stapler group developed a benign esophageal stricture (P=NS). The mean follow-up time was 24 months, and the rates of freedom from benign stricture and survival were comparable in each group. Conclusions: Performing cervical esophagogastric anastomoses using a circular mechanical stapler had a shorter operating time and a comparable outcome to the hand-sewn method. The circular mechanical stapler could be used as an alternative for cervical esophagogastric anastomosis after resection for esophageal squamous cell cancer. ? 2004 Elsevier B.V. All rights reserved.
SDGs
Other Subjects
adult; aged; anastomosis; article; cancer patient; cancer survival; cervical esophagogastric anastomosis; clinical trial; controlled clinical trial; controlled study; esophagus carcinoma; esophagus resection; esophagus stricture; female; follow up; hospital; human; intermethod comparison; major clinical study; male; mortality; operation duration; postoperative period; priority journal; prospective study; randomized controlled trial; squamous cell carcinoma; surgical stapling; surgical technique; Aged; Anastomosis, Surgical; Carcinoma, Squamous Cell; Disease-Free Survival; Esophageal Neoplasms; Esophageal Stenosis; Esophagus; Female; Hospital Mortality; Humans; Male; Middle Aged; Postoperative Complications; Prospective Studies; Stomach; Surgical Staplers; Suture Techniques
Type
journal article