Comparison of stapled or hand-sewn anastomosis techniques in surgical treatment for esophageal cancer

Abstract

Objective: This study was performed to compare stapled and hand sewn techniques for esophagogastric anastomosis on esophagus cancer surgery. The study was focused on to the effect of esophagogastric anastomosis techniques on mortality, morbidity, median operation and hospitalization time.

Material and Methods: A retrospective study was undertaken in 60 patients with eosophagial cancer who underwent resection and anastomosis. Twenty eight patients were operated with transhiatal (48%) and others with transthoracic (54%) approach. Patients were classified to perform stapled anastomosis (Group 1) and hand sewn anastomosis (Group 2). Hand sewn anastomosis technique was performed in 43 (72%) and stapled anastomosis technique was performed in 17 cases (% 28).

Results: The groups were similar regarding age, sex, ASA scores, tumor localization and stage, for the operative approach. Major morbidity was present in 5 patients (30%) in Group 1 and 19 patients (44%) in Group 2. The number of anastomosis leaks was 4 in Group 1 (23%) and 6 in Group 2 (14%). Mortality was encountered in 1 patient in Group 1 (6%) and 5 patients in Group 2 (11%). The mean hospital stay was determined to be 18.4 ± 11.8 days for Group 1 and 16.33 ± 8.1 days for Group 2. No statistically significant difference was found between the groups regarding major morbidity, mortality and mean hospital stay (p>0.05).

Conclusion: In our study, the techniques of anastomosis via hand sewn or stapled were not found to be superior to one another. The practice and skill of the surgeon should be determinant about the application of the methods.