Hand-sewn<i>vs</i>linearly stapled esophagogastric anastomosis for esophageal cancer: A meta-analysis

Deng, Xu; Liu, Quan‐Xing; Zhou, Dong; Min, Jia-Xin; Dai, Ji‐Gang

doi:10.3748/wjg.v21.i15.4757

Cited by 89 publications

(60 citation statements)

References 30 publications

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“…Multiple reports have compared anastomotic leak rates among various techniques. A recent meta‐analysis found lower leak rates with a linear stapled esophagogastric anastomosis compared to a completely hand‐sewn technique . A separate meta‐analysis by the same authors found no difference in leak rates between linear stapled and circular stapled esophagogastric anastomoses, but there were significant different stricture rates .…”

Section: Discussionmentioning

confidence: 98%

“…Different esophagogastric anastomotic techniques have their own characteristics, and multiple reports have compared anastomotic complications among various techniques . A side‐to‐side anastomosis has been generally defined as a semi‐mechanical liner stapler procedure, and in several studies it has been shown to reduce the incidence of postoperative anastomotic strictures without increasing the rate of anastomotic fistulae . At present, there are relatively few studies using a mechanical anastomosis, especially as it is applied to cervical anastomoses during MIE procedures .…”

Section: Introductionmentioning

confidence: 99%

“…5,6 A side-to-side anastomosis has been generally defined as a semi-mechanical liner stapler procedure, and in several studies it has been shown to reduce the incidence of postoperative anastomotic strictures without increasing the rate of anastomotic fistulae. [6][7][8][9][10] At present, there are relatively few studies using a mechanical anastomosis, especially as it is applied to cervical anastomoses during MIE procedures. 11,12 Importantly, there is insufficient evidence in the literature to definitively recommend one anastomotic technique over another.…”

Section: Introductionmentioning

confidence: 99%

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Totally mechanical linear stapled anastomosis for minimally invasive Ivor Lewis esophagectomy: Operative technique and short‐term outcomes

Gao

Pan

et al. 2020

Thoracic Cancer

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Background Anastomosis is one of the important factors affecting anastomotic complications after esophagectomy, and multiple reports have compared anastomotic complications among various techniques. However, there is insufficient evidence in the literature to definitively recommend one anastomotic technique over another. Method We retrospectively evaluated 34 consecutive patients who underwent an improved totally mechanical side‐to‐side: posterior‐to‐posterior linear stapled (TM‐STS) technique for minimally invasive Ivor Lewis esophagogastric anastomosis, performed by a single surgeon between February 2015 to November 2017. The operative techniques and short‐term outcomes are analyzed in this study. Results There were no conversions to an open approach and a complete resection was achieved in all patients undergoing this improved procedure. During the first half of the series, the median operation time was 355 minutes, ranging from 257 to 480 minutes. Over the second half of this series, the median operation time was reduced to 256 minutes. There were no mortalities or serious postoperative complications. Only one patient (2.9%) had an anastomotic leak, which resolved without intervention. Another patient (2.9%) experienced transient, delayed conduit emptying which upper gastrointestinal radiography determined was due to a mechanical obstruction caused by an abnormally long gastric tube in the chest cavity. Conclusions The results of our study suggest that this improved TM‐STS technique is safe and effective for minimally invasive Ivor Lewis esophagectomy, and can be considered as one of the alternative procedure for patients with lower esophageal as well as Siewert types I/II gastroesophageal junction carcinoma.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Totally mechanical linear stapled anastomosis for minimally invasive Ivor Lewis esophagectomy: Operative technique and short‐term outcomes

Gao

Pan

et al. 2020

Thoracic Cancer

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“…Por el contrario, en un metaanálisis de Deng, et al, se presentó una tasa menor de fugas en las anastomosis laterolaterales con sutura mecánica lineal en comparación con la sutura manual. La diferencia con nuestros resultados puede deberse a la falta de homogeneidad en la técnica utilizada, pues se in-cluyeron pacientes con diferentes tipos de anastomosis con sutura mecánica 28 . En la presente serie, no se encontró una diferencia significativa en las complicaciones al usar sutura mecánica circular o lineal, en forma similar a lo informado por Zhou, et al, en su metaanálisis sobre fugas de las anastomosis; ellos informaron también un aumento de las estenosis, un aspecto que no fue evaluado en este estudio 29 .…”

Section: Discussionunclassified

Esofagectomía en un centro suramericano de tratamiento del cáncer

et al. 2018

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ResumenIntroducción. Suramérica es un área geográfica de incidencia intermedia de cáncer de esófago, con un aumento progresivo y diagnóstico temprano poco común. A pesar de que la resección quirúrgica es la piedra angular del tratamiento, todavía la tasa de supervivencia es pobre y la de complicaciones es alta. El objetivo del presente estudio fue describir la frecuencia de complicaciones de la esofagectomía para el tratamiento del cáncer de esófago extirpable en un centro de tratamiento para el cáncer en Bogotá, Colombia. Pacientes y métodos. Se hizo una revisión retrospectiva de una base de datos prospectiva. Se incluyeron 30 pacientes sometidos a esofagectomía por cáncer de esófago, 22 por técnica abierta y 8 mediante laparoscopia, en un único centro de tratamiento para el cáncer entre 2012 y 2016. Se documentaron las complicaciones posoperatorias y se comparó su frecuencia, incluyendo las fugas de la anastomosis, entre la anastomosis latero-lateral y la término-lateral, entre la esofagectomía cervical y la intratorácica; entre la sutura mecánica y la manual, y entre la sutura mecánica circular y la lineal. Resultados. Se presentaron complicaciones posoperatorias en 56,7 % de los pacientes y, fugas de la anastomosis, en 30 %. La tasa de mortalidad fue de 6,7 %. Las fugas de la anastomosis fueron más frecuentes en pacientes mayores y mujeres (p=0,0116 y p=0,0301, respectivamente). No se presentó diferencia estadísticamente significativa entre las diferentes técnicas anastomóticas. Conclusiones. Los resultados de este estudio demuestran que, a pesar de ser un área de incidencia intermedia de cáncer de esófago, esta sigue siendo una enfermedad poco frecuente con una tasa de complicaciones representativa. Los resultados sugieren que las fugas anastomóticas se presentan más frecuentemente en pacientes ancianos y mujeres. Palabras clave: esófago; neoplasias esofágicas; esofagectomía; laparoscopía. ARTÍCULO ORIGINAL 72Borráez BA, Montoya JA, Meneses PA, Abadía M, Pinilla RE, Oliveros R Rev Colomb Cir. 2018;33:71-78 variable (0,3 a 22 %), influenciada por la experiencia del cirujano y su práctica en centros de alto volumen de tratamiento [4][5][6] . Las complicaciones muestran cifras representativas de mortalidad (26 a 64 %), y generan un retorno tardío a las actividades, retraso del tratamiento adyuvante e incremento de costos para los sistemas de salud. Por otra parte, las fugas de las anastomosis representan una complicación particularmente seria, reportada en 3,8 a 11,7 % de los pacientes, las cuales pueden requerir manejo médico o quirúrgico según su gravedad [4][5][6] . A pesar de que el cáncer de esófago no es un problema de salud en nuestra región, como sí lo son el de estómago y el colorrectal, su aumento progresivo obliga a evaluar nuestro desempeño en el tratamiento de esta enfermedad cada vez más frecuente.El objetivo de este estudio fue describir la frecuencia de complicaciones de la esofagectomía para el cáncer de esófago extirpable, en un centro de tratamiento para el cáncer en Bogotá, Colombia. I...

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“…7,31 However, the hand-sewn method performed thoracoscopically cannot be compared to the robotic-assisted hand-sewn method. In a review by Deng et al, the stapled methods were shown to lead to a reduced leak rate; 32 however, this does not prove the superiority of this method.…”

Section: Intrathoracic Anastomosis In Ramiementioning

confidence: 99%

Surgical robotics for esophageal cancer

Grimminger

Ruurda

Det

et al. 2018

Annals of the New York Academy of Sciences

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We present an update on robotic techniques and their advantages and use in esophageal cancer surgery. Recent work has shown tremendous progress in robotic-assisted minimally invasive esophagectomy (RAMIE) and lymphadenectomy for esophageal cancer, as well as benefits of robotic surgery in high upper esophageal tumors and T4b disease. We discuss the different RAMIE techniques, especially for intrathoracic anastomosis. The ongoing ROBOT trial had demonstrated superiority of robotic esophageal cancer surgery over open esophagectomy. There are various putative technical advantages of RAMIE over minimally invasive esophagectomy, which need to be proven in future trials.

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Hand-sewnvslinearly stapled esophagogastric anastomosis for esophageal cancer: A meta-analysis

Abstract: This meta-analysis indicates that the LS technique contributes to a reduced rate of leakage and stricture compared with the HS method.

Cited by 89 publications

References 30 publications

Totally mechanical linear stapled anastomosis for minimally invasive Ivor Lewis esophagectomy: Operative technique and short‐term outcomes

Totally mechanical linear stapled anastomosis for minimally invasive Ivor Lewis esophagectomy: Operative technique and short‐term outcomes

Esofagectomía en un centro suramericano de tratamiento del cáncer

Surgical robotics for esophageal cancer

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