A comparison of cervical delta-shaped anastomosis and circular stapled anastomosis after esophagectomy. Issue 1 (December 2017)

• Record Type: Journal Article
• Authors: Huang, Chen; Xu, Xunhai; Zhuang, Binbin; Chen, Wenshu; Xu, Xunyu; Wang, Chao; Lin, Shengmei
• Is Part Of: World journal of surgical oncology. Volume 15:Issue 1(2017)
• Page Start: 1
• Page End: 6
• Publication Date: 2017-12
• Subjects: Esophageal cancers -- Esophagogastric anastomosis -- Anastomotic leakage -- Stenosis; Cancer -- Surgery -- Periodicals; Tumors -- Periodicals; Tumors -- Surgery -- Periodicals; Surgery, Operative -- Periodicals; 616.994059
• DOI: 10.1186/s12957-017-1097-4
• Languages: English
• ISSNs: 1477-7819

Abstract

Abstract Background The delta-shaped anastomosis has been reported to reduce anastomotic complications for a decade. However, little has been written comparing this technique with the circular stapler technique. The objective of this retrospective study was to assess the safety and efficacy of cervical delta-shaped anastomosis after esophagectomy. Methods Medical records of patients with esophageal squamous cell carcinoma who underwent McKeown (three-incision) esophagectomy between September 2013 and June 2015 were reviewed. Either circular stapled anastomosis (CSA) or delta-shaped anastomosis (DSA) was performed at the cervical stage. The clinical characteristics and short-term outcome were retrospectively assessed to identify the differences between the two groups. Results A total of 81 patients were included in this study. The clinical characteristics were similar between the two groups. Cervical anastomotic leakage occurred in 3 (7.7%) of 39 patients in the DSA group and in 8 (19%) of 42 patients in the CSA group (P = 0.197). The average anastomotic orifice width was 16.1 ± 4.9 mm and 11.7 ± 2.2 mm, respectively (P < 0.001). The incidence of anastomotic stenosis was 2.6% (1/39) and 23.5% (10/42) in the DSA and CSA groups, respectively (P = 0.007). There was no significant difference in surgical duration, blood loss, pulmonary complication, postoperative mortality, time of hospitalisation and time of ICU stay between the two groups. Conclusions Delta-shaped anastomosis may be an effective alternative method for gastroesophageal anastomosis after esophagectomy, with lower incidence of leakage and stenosis.