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Article: Comparison of hand-sewn and stapled esophagogastric anastomosis after esophageal resection for cancer: A prospective randomized controlled trial

TitleComparison of hand-sewn and stapled esophagogastric anastomosis after esophageal resection for cancer: A prospective randomized controlled trial
Authors
Issue Date1997
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com
Citation
Annals Of Surgery, 1997, v. 226 n. 2, p. 169-173 How to Cite?
AbstractObjective: The objective of this study was to compare the hand-sewn and stapled methods in esophagogastric anastomosis. Summary Background Data: After esophageal resection for cancer, the relative merits of the hand-sewn and the stapled methods of esophagogastric anastomosis, especially regarding leakage and stricture rates, have not adequately been studied. Methods: A prospective randomized controlled trial was undertaken in 122 patients with squamous cell cancer of the thoracic esophagus who underwent a Lewis-Tanner esophagectomy. Patients were stratified according to esophageal size, based on the diameter of the divided esophagus (< or ≤30 mm) and then were randomized to have either a hand-sewn or a stapled anastomosis. Results: The mean total operating times (standard error of the mean) when the hand-sewn and the stapled methods were used were 214 (4) minutes and 217 (3.4) minutes, respectively (p = not significant [NS]). The respective in vivo proximal resection margins (standard error of the mean) were 8 (0.4) cm and 7.6 (0.4) cm (p = NS). Leakage rates were 1.6% and 4.9% (p = NS). Excluding hospital deaths, patients with leakage or anastomotic recurrence, and those who received radiation therapy to histologically infiltrated resection margin, anastomotic stricture was found in 5 (9.1%) of 55 patients in the hand-sewn group and 20 (40%) of 50 in the stapler group (p = 0.0003). The difference in stricture rates was significant in small as well as large esophagi. Anastomotic recurrence developed in only one patient in each group. Conclusions: The authors conclude that both methods were safe, but the stapled technique resulted in more stricture formation.
Persistent Identifierhttp://hdl.handle.net/10722/84324
ISSN
2015 Impact Factor: 8.569
2015 SCImago Journal Rankings: 4.503
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLaw, Sen_HK
dc.contributor.authorFok, Men_HK
dc.contributor.authorChu, KMen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T08:51:36Z-
dc.date.available2010-09-06T08:51:36Z-
dc.date.issued1997en_HK
dc.identifier.citationAnnals Of Surgery, 1997, v. 226 n. 2, p. 169-173en_HK
dc.identifier.issn0003-4932en_HK
dc.identifier.urihttp://hdl.handle.net/10722/84324-
dc.description.abstractObjective: The objective of this study was to compare the hand-sewn and stapled methods in esophagogastric anastomosis. Summary Background Data: After esophageal resection for cancer, the relative merits of the hand-sewn and the stapled methods of esophagogastric anastomosis, especially regarding leakage and stricture rates, have not adequately been studied. Methods: A prospective randomized controlled trial was undertaken in 122 patients with squamous cell cancer of the thoracic esophagus who underwent a Lewis-Tanner esophagectomy. Patients were stratified according to esophageal size, based on the diameter of the divided esophagus (< or ≤30 mm) and then were randomized to have either a hand-sewn or a stapled anastomosis. Results: The mean total operating times (standard error of the mean) when the hand-sewn and the stapled methods were used were 214 (4) minutes and 217 (3.4) minutes, respectively (p = not significant [NS]). The respective in vivo proximal resection margins (standard error of the mean) were 8 (0.4) cm and 7.6 (0.4) cm (p = NS). Leakage rates were 1.6% and 4.9% (p = NS). Excluding hospital deaths, patients with leakage or anastomotic recurrence, and those who received radiation therapy to histologically infiltrated resection margin, anastomotic stricture was found in 5 (9.1%) of 55 patients in the hand-sewn group and 20 (40%) of 50 in the stapler group (p = 0.0003). The difference in stricture rates was significant in small as well as large esophagi. Anastomotic recurrence developed in only one patient in each group. Conclusions: The authors conclude that both methods were safe, but the stapled technique resulted in more stricture formation.en_HK
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.comen_HK
dc.relation.ispartofAnnals of Surgeryen_HK
dc.rightsAnnals of Surgery. Copyright © Lippincott Williams & Wilkins.en_HK
dc.titleComparison of hand-sewn and stapled esophagogastric anastomosis after esophageal resection for cancer: A prospective randomized controlled trialen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0003-4932&volume=226&spage=169&epage=173&date=1997&atitle=Comparison+of+hand-sewn+and+stapled+esophagogastric+anastomosis+after+esophageal+resection+for+cancer+-+a+prospective+randomized+controlled+trialen_HK
dc.identifier.emailLaw, S: slaw@hku.hken_HK
dc.identifier.emailChu, KM: chukm@hkucc.hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityLaw, S=rp00437en_HK
dc.identifier.authorityChu, KM=rp00435en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1097/00000658-199708000-00008en_HK
dc.identifier.pmid9296510-
dc.identifier.pmcidPMC1190951-
dc.identifier.scopuseid_2-s2.0-0344404401en_HK
dc.identifier.hkuros28699en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0344404401&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume226en_HK
dc.identifier.issue2en_HK
dc.identifier.spage169en_HK
dc.identifier.epage173en_HK
dc.identifier.isiWOS:A1997XV48200008-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLaw, S=7202241293en_HK
dc.identifier.scopusauthoridFok, M=7005879262en_HK
dc.identifier.scopusauthoridChu, KM=7402453538en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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