Retrospective Analysis of Hand-sewn versus Stapled Esophagojejunostomy after Total Gastrectomy: A single Center Experience

Abstract

Introduction: Stapled esophagojejunostomy is commonly used nowadays as it is time saving technique withaccepted results in comparison with hand sewn anastomosis. This retrospective study aims to compare between thetwo techniques as regarding short term surgical outcome in two groups of patients during open total gastrectomywith roux en y esophagojejunostomy for gastric carcinoma.Patients and methods: The study included 29 adult patients with gastric cancer who underwent TG withroux en-Y esophagojejunostomy in the Department of upper GIT surgery in Ain shams university hospitals betweenFebruary 2019 and October 2023. The patients were divided into 2 groups ac-cording to the technique of EJA: handsewn(13 cases) or stapled (16 cases). We compared the two groups in terms of the operative time, occurrence ofcomplications (focusing on bleeding, anastomotic leakage, stricture and abdominal abscess) and length of hospitalstay.Results: There were no significant differences in duration of the surgery (P=0.13), blood loss (P=0.29), or lengthof postoperative hospital stay (P=0.9) among the groups. The most serious complication was anastomotic leakage,with 3 cases in both groups, 2 of them were suffering only radiological leakage (P=0.51). During the follow upperiod the anastomotic stricture occurred in in 1 (7.7%) cases with hand-sewn anastomosis (P=0.67) and 2(12.5%) cases with stapled anastomosis.Conclusions: In our study there were no significant differences in the short and midterm surgical outcomebetween hand-sewn and stapled esophago-jejunal anastomosis in total gastrectomy.