Comparison of Postoperative Outcomes of Hand-Sewn Versus Stapled Esophago-Jejunal Anastomosis during Total Gastrectomy | ||
| Ain Shams Journal of Surgery | ||
| Volume 18, Issue 4, October 2025, Pages 300-308 PDF (426.61 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/asjs.2025.400943.1216 | ||
| Authors | ||
| Ahmed Mohamed Amer; Ahmed Mostafa Mahmoud; Sharif Ahmed Abdalkarim; Hussam Mohamed Farid* | ||
| Surgical Oncology, GIT Surgical Oncology Unit, National Cancer Instuite, Cairo University, Caitro, Egypt | ||
| Abstract | ||
| Introduction: The optimal technique for esophagojejunal anastomosis following total gastrectomy remains debated. Aim of work: This study compares perioperative outcomes and postoperative complications between stapled and hand-sewn anastomosis techniques. Patients and methods: A retrospective cohort study was conducted on 102 patients who underwent esophagojejunal anastomosis after total gastrectomy. Patients were divided into two groups: stapled anastomosis (n = 44) and hand-sewn anastomosis (n = 58). Key parameters analyzed included operative time, intraoperative blood loss, hospital stay duration, time to oral intake, postoperative complications (leakage, stricture, infection), recurrence, and mortality. Statistical comparisons were performed to assess significant differences. Results: Stapled anastomosis was associated with significantly shorter operative time (180.2 ± 14.8 vs. 230.4 ± 8.6 minutes, p < 0.05) and reduced intraoperative blood loss (170.3 ± X vs. 240.4 ± X mL, p < 0.05). Hospital stay was shorter in the stapled group (10–13 vs. 15–18 days, p < 0.05), and oral feeding was initiated earlier (7–9 vs. 9–11 days, p < 0.05). No significant differences were observed in anastomotic leaks, infections, or pneumonia. A slightly higher, though non-significant, rate of anastomotic stricture was noted in the stapled group. Mortality and recurrence rates were comparable between groups. Conclusion: Stapled esophagojejunal anastomosis offers advantages in operative time, blood loss, and recovery without increasing major complications. Despite a non-significant rise in stricture rates, overall outcomes support its use in clinical practice. Further randomized studies are warranted to validate long-term oncologic safety. | ||
| Keywords | ||
| Esophagojejunal anastomosis; total gastrectomy; stapled technique; hand-sewn technique; postoperative outcomes | ||
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