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Article: Comparison of a single layer continuous hand-sewn method and circular stapling in 580 oesophageal anastomoses

TitleComparison of a single layer continuous hand-sewn method and circular stapling in 580 oesophageal anastomoses
Authors
Issue Date1991
PublisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www.bjs.co.uk
Citation
British Journal Of Surgery, 1991, v. 78 n. 3, p. 342-345 How to Cite?
AbstractA total of 611 patients with carcinoma of the oesophagus or gastric cardia were operated on between July 1982 and December 1989. Resection was performed in 491 patients (one-stage, 483; two-stage, eight), bypass operation in 97, and 23 had exploration alone. The anastomoses of 580 patients with one-stage resection and bypass operations were evaluated. Hand-sewn anastomosis using a single layer of continuous absorbable monofilament suture was performed in 304 patients (221 resections and 83 bypasses). A stapled anastomosis was performed on 276 patients (262 resections and 14 bypasses). Following resection, there were 11 (5 per cent) anastomotic leaks in the hand-sewn group and ten (3.8 per cent) in the stapled anastomosis group (P = 0.69). Excluding anastomotic leaks, hospital mortality and anastomotic recurrence, stricture occurred in 18 of 172 hand-sewn anastomoses (10.5 per cent) and in 57 of 195 stapled anastomoses (29.2 per cent) (P < 0.001). In patients who had bypass operations there were 12 anastomotic leaks, ten in the hand-sewn group (12.0 per cent) and two in the stapled anastomosis group (14.3 per cent). Only two of the discharged patients with bypass developed anastomotic strictures, a low incidence probably because of short survival. In addition, there were 245 subsidiary anastomoses made in the abdomen by the hand-sewn method as part of the reconstructive procedure, and there was one leak. The results of this non-randomized study suggest that hand-sewn anastomosis using a single layer continuous technique for the oesophagus is as safe as the use of circular staplers; hand-sewn anastomosis is less likely to become stenotic.
Persistent Identifierhttp://hdl.handle.net/10722/172656
ISSN
2015 Impact Factor: 5.596
2015 SCImago Journal Rankings: 2.966
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorFok, Men_HK
dc.contributor.authorAhChong, AKen_HK
dc.contributor.authorCheng, SWKen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2012-10-30T06:24:03Z-
dc.date.available2012-10-30T06:24:03Z-
dc.date.issued1991en_HK
dc.identifier.citationBritish Journal Of Surgery, 1991, v. 78 n. 3, p. 342-345en_HK
dc.identifier.issn0007-1323en_HK
dc.identifier.urihttp://hdl.handle.net/10722/172656-
dc.description.abstractA total of 611 patients with carcinoma of the oesophagus or gastric cardia were operated on between July 1982 and December 1989. Resection was performed in 491 patients (one-stage, 483; two-stage, eight), bypass operation in 97, and 23 had exploration alone. The anastomoses of 580 patients with one-stage resection and bypass operations were evaluated. Hand-sewn anastomosis using a single layer of continuous absorbable monofilament suture was performed in 304 patients (221 resections and 83 bypasses). A stapled anastomosis was performed on 276 patients (262 resections and 14 bypasses). Following resection, there were 11 (5 per cent) anastomotic leaks in the hand-sewn group and ten (3.8 per cent) in the stapled anastomosis group (P = 0.69). Excluding anastomotic leaks, hospital mortality and anastomotic recurrence, stricture occurred in 18 of 172 hand-sewn anastomoses (10.5 per cent) and in 57 of 195 stapled anastomoses (29.2 per cent) (P < 0.001). In patients who had bypass operations there were 12 anastomotic leaks, ten in the hand-sewn group (12.0 per cent) and two in the stapled anastomosis group (14.3 per cent). Only two of the discharged patients with bypass developed anastomotic strictures, a low incidence probably because of short survival. In addition, there were 245 subsidiary anastomoses made in the abdomen by the hand-sewn method as part of the reconstructive procedure, and there was one leak. The results of this non-randomized study suggest that hand-sewn anastomosis using a single layer continuous technique for the oesophagus is as safe as the use of circular staplers; hand-sewn anastomosis is less likely to become stenotic.en_HK
dc.languageengen_US
dc.publisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www.bjs.co.uken_HK
dc.relation.ispartofBritish Journal of Surgeryen_HK
dc.subject.meshAnastomosis, Surgicalen_US
dc.subject.meshConstriction, Pathologicen_US
dc.subject.meshEsophageal Neoplasms - Surgeryen_US
dc.subject.meshEsophagus - Pathology - Surgeryen_US
dc.subject.meshHumansen_US
dc.subject.meshPostoperative Complicationsen_US
dc.subject.meshSurgical Staplersen_US
dc.subject.meshSuture Techniquesen_US
dc.titleComparison of a single layer continuous hand-sewn method and circular stapling in 580 oesophageal anastomosesen_HK
dc.typeArticleen_HK
dc.identifier.emailCheng, SWK: wkcheng@hkucc.hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityCheng, SWK=rp00374en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1002/bjs.1800780323-
dc.identifier.pmid2021852-
dc.identifier.scopuseid_2-s2.0-0026087602en_HK
dc.identifier.volume78en_HK
dc.identifier.issue3en_HK
dc.identifier.spage342en_HK
dc.identifier.epage345en_HK
dc.identifier.isiWOS:A1991FE47300021-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridFok, M=7005879262en_HK
dc.identifier.scopusauthoridAhChong, AK=6507766297en_HK
dc.identifier.scopusauthoridCheng, SWK=7404684779en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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