Background: Mechanical stapling is a commonly utilized alternative to the traditional hand-sewn method for esophagojejunal anastomosis (EJA) during total gastrectomy. This retrospective study sought to evaluate and compare the surgical outcomes of stapled versus hand-sewn EJA in patients undergoing open total gastrectomy for gastric cancer.
Patients and methods: The medical records of all patients who underwent total gastrectomy followed by esophagojejunal anastomosis (EJA) for the treatment of adenocarcinoma of the esophagojejunal junction (EGJ) and proximal stomach at Minia University Hospital between 2020 and 2023 were reviewed. The patients were categorized into two groups: Group I consisted of those who received stapled EJA, while Group II comprised those who received hand-sewn EJA. A comparison between the groups was conducted based on operative time, length of hospital stay, and the incidence of complications, with particular attention to anastomotic leakage, stricture, and infection.
Results: The study included a total of 27 patients: 17 (63%) underwent stapled EJA, while 10 (37%) had a hand-sewn EJA. Statistically significant differences were observed between the two groups in terms of operative time (p value = 0.000), blood loss (p value = 0.002), average time to remove the nasogastric tube (NGT) (p value = 0.01), average time to remove the drain (p value = 0.002), and average hospital stay (p value = 0.000).
Conclusion: This study concluded that stapled EJA is a safe and efficient method for performing esophagojejunostomy, providing faster execution, shorter hospital stays, and no increased risk of benign anastomotic stricture formation compared to hand-sewn anastomosis.