Esophagojejunostomy after total gastrectomy: handsewn or stapler technique?

Fábio Lopes André Fonseca dos Reis Bruno Juste Werneck Côrtes Dreyfus Silva Fabrini Henrique Ribeiro Lima Luiz Carlos Gomes Rocha About the authors

BACKGROUND: The authors report a observational study comparing the surgical outcomes in patients underwent total gastrectomy for gastric cancer and Roux-en-Y end-to-end esophagojejunostomy. METHODS: A mechanical EEA stapler or conventional manual suturing was used. The study was realized in Israel Pinheiro Governor Hospital from January 1997 to May 2002. The surgical outcomes of 16 patients in whom stapling was used (stapler group) and 24 patients in whom manual suturing was done (manual group) were compared. They were: complications incidence, re-operation, hospital stay and mortality. RESULTS: In each group, 37% of patients did not have any kind of complications. About anastomotic complications (leakage and intraabdominal abscess), there was 9 in manual group and anyone in mechanical group (p=0,006). Morbidity and hospital stay were higher in manual group. There was one obit in each group. CONCLUSION: Surgical complications, morbidity and hospital stay were higher in manual group. This study suggest a higher viability of mechanical suturing.

Stomach neoplasms; Gastrectomy; Surgical staplers; Manual suture

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