Side-to-side, end-to-end, embedded anastomosis versus end-to-side anastomosis in patients with esophageal carcinoma：A retrospective, controlled study

Abstract

Background Anastomotic leakage is one of the most serious postoperative complications of esophageal carcinoma. A new method of anastomosis has been adopted to reduce the incidence of anastomotic leakage. The aim of this study was to verify the safety and effectiveness of this new anastomosis method by comparing with the traditional anastomosis method. Methods A total of 121 patients with esophageal cancer from January 2020 to January 2022 in our department were included. They were divided into two groups according to the different methods of esophagogastrostomy: Side-to-side, end-to-end, embedded anastomosis group (SEE group, n=68) and traditional end-to-side anastomosis group (TE group, n=69). On the 7th day after operation, esophagography was performed to confirm the existence of anastomotic leakage, dysphagia, anastomotic stenosis, and gastroesophageal reflux. Results The incidence of anastomotic leakage in TE group and SEE group were 14.5% and 3.4%, respectively, with statistical significance(p＜0.05). The incidence of anastomotic stenosis in TE group was 21%, while in SEE group it was 3.4%. These differences were statistically significant(p＜0.01). The incidence of reflux in the TE group and the SEE group was 24.2% and 8.5%, respectively, with statistical significance(p＜0.05). The first esophagography after operation showed that the incidence of swallowing disorder was 27.4% in TE group and 57.6% in SEE group. These differences were statistically significant(p＜0.01). However, the incidence of swallowing disorder in TE group and SEE group was 9.7% and 15.3%, respectively, with no significant difference after 3 months (p＞0.05). Conclusion SEE anastomosis is a safe and effective surgical method, which is worthy of clinical application.