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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2015

01-10-2015 | Gastrointestinal Oncology

Does the Single-Stapling Technique for Circular-Stapled Esophagojejunostomy Reduce Anastomotic Complications After Laparoscopic Total Gastrectomy?

Authors: Toshiyuki Kosuga, MD, PhD, Naoki Hiki, MD, PhD, Souya Nunobe, MD, PhD, Manabu Ohashi, MD, PhD, Takeshi Kubota, MD, PhD, Satoshi Kamiya, MD, Takeshi Sano, MD, PhD, Toshiharu Yamaguchi, MD, PhD

Published in: Annals of Surgical Oncology | Issue 11/2015

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Abstract

Background

Laparoscopic total gastrectomy (LTG) is used for early gastric cancer (EGC) in the upper stomach. However, the incidences of postoperative anastomotic complications such as leakage and stricture remain high. This study investigated whether using a single-stapling technique (SST) instead of a hemi-double-stapling technique (HDST) for intracorporeal circular-stapled esophagojejunostomy could reduce anastomotic complications after LTG.

Methods

This retrospective study included 136 patients with EGC treated by LTG with intracorporeal circular-stapled esophagojejunostomy. Originally, HDST was used for esophagojejunostomy in 71 patients (original group). Thereafter, the esophagojejunostomy procedure was modified, and SST was used in a further 65 patients (modified group). The impact of the anastomotic procedure (SST or HDST) on anastomotic complications after LTG was determined by uni- and multivariate analyses.

Results

The incidence of anastomotic complications was significantly lower in the modified group (7.7 %) than in the original group (22.5 %; P = 0.017). The frequency of anastomotic leakage was lower in the modified group (3.1 %) than in the original group (9.9 %), although the difference was not statistically significant. Meanwhile, the frequency of anastomotic stricture was significantly less common in the modified group (6.2 %) than in the original group (18.3 %; P = 0.032). Multivariate analysis showed that anastomotic procedure with SST was significantly associated with a lower rate of postoperative anastomotic complications (odds ratio [OR], 0.217; 95 % confidence interval [CI], 0.063–0.631; P = 0.004), as was the operation time (OR, 0.237; 95 % CI 0.082–0.667; P = 0.007).

Conclusions

The use of SST for intracorporeal circular-stapled esophagojejunostomy could reduce anastomotic complications after LTG.
Appendix
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Metadata
Title
Does the Single-Stapling Technique for Circular-Stapled Esophagojejunostomy Reduce Anastomotic Complications After Laparoscopic Total Gastrectomy?
Authors
Toshiyuki Kosuga, MD, PhD
Naoki Hiki, MD, PhD
Souya Nunobe, MD, PhD
Manabu Ohashi, MD, PhD
Takeshi Kubota, MD, PhD
Satoshi Kamiya, MD
Takeshi Sano, MD, PhD
Toshiharu Yamaguchi, MD, PhD
Publication date
01-10-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 11/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4417-3

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