The Impact of Circular Stapler Size on the Incidence of Cervical Anastomotic Stricture After Esophagectomy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-03-07

AUTHORS

Takahiro Hosoi, Tetsuya Abe, Norihisa Uemura, Eiji Higaki, Ryosuke Kawai, Jiro Kawakami, Byonggu An, Masato Nagino, Yasuhiro Shimizu

ABSTRACT

BACKGROUND: Cervical anastomotic stricture after esophagectomy is a serious complication that adversely affects postoperative recovery, nutritional status and quality of life. Cervical anastomosis by a circular stapler (CS) has been widely accepted as a simple and convenient method, but anastomotic strictures are likely to occur. The aim of this study was to investigate an association between CS size and the incidence of anastomotic stricture after cervical esophagogastric anastomosis performed by a CS. METHODS: Between April 2011 and March 2016, 236 consecutive patients underwent cervical esophagogastric anastomosis by a CS via a retrosternal route after esophagectomy for esophageal cancer. These patients were divided into according to CS size for the procedure as follows: small-sized (25 mm) CS group (SG, n = 116) and large-sized (28 or 29 mm) CS group (LG, n = 120). The clinical data of patients were analyzed retrospectively to compare the two groups. RESULTS: Overall, anastomotic strictures were observed in 90 patients (38%). The incidence of anastomotic stricture was significantly lower in the LG than the SG (23% vs. 53%, p < 0.001) (Table 3). Chronic obstructive pulmonary disease (COPD: FEV1.0% <70%) (OR 2.35, 95% CI = 1.09-5.14; p = 0.029), anastomotic leakage (OR 8.97, 95% CI = 2.69-41.30; p < 0.001), and a small-sized CS (OR 3.42, 95% CI = 1.82-6.62; p < 0.001) were independent risk factors for anastomotic stricture in the multivariate analysis. CONCLUSIONS: If possible, a large-sized CS should be used to prevent cervical anastomotic strictures when performing cervical anastomoses by CS. More... »

PAGES

1-10

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00268-019-04938-8

DOI

http://dx.doi.org/10.1007/s00268-019-04938-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1112606933

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30847524


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    "description": "BACKGROUND: Cervical anastomotic stricture after esophagectomy is a serious complication that adversely affects postoperative recovery, nutritional status and quality of life. Cervical anastomosis by a circular stapler (CS) has been widely accepted as a simple and convenient method, but anastomotic strictures are likely to occur. The aim of this study was to investigate an association between CS size and the incidence of anastomotic stricture after cervical esophagogastric anastomosis performed by a CS.\nMETHODS: Between April 2011 and March 2016, 236 consecutive patients underwent cervical esophagogastric anastomosis by a CS via a retrosternal route after esophagectomy for esophageal cancer. These patients were divided into according to CS size for the procedure as follows: small-sized (25\u00a0mm) CS group (SG, n\u2009=\u2009116) and large-sized (28 or 29\u00a0mm) CS group (LG, n\u2009=\u2009120). The clinical data of patients were analyzed retrospectively to compare the two groups.\nRESULTS: Overall, anastomotic strictures were observed in 90 patients (38%). The incidence of anastomotic stricture was significantly lower in the LG than the SG (23% vs. 53%, p\u2009<\u20090.001) (Table\u00a03). Chronic obstructive pulmonary disease (COPD: FEV1.0% <70%) (OR 2.35, 95% CI\u2009=\u20091.09-5.14; p\u2009=\u20090.029), anastomotic leakage (OR 8.97, 95% CI\u2009=\u20092.69-41.30; p\u2009<\u20090.001), and a small-sized CS (OR 3.42, 95% CI\u2009=\u20091.82-6.62; p\u2009<\u20090.001) were independent risk factors for anastomotic stricture in the multivariate analysis.\nCONCLUSIONS: If possible, a large-sized CS should be used to prevent cervical anastomotic strictures when performing cervical anastomoses by CS.", 
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