Esophagogastrostomy by side-to-side anastomosis in prevention of anastomotic stricture: a randomized clinical trial / 中华外科杂志
Chinese Journal of Surgery
;
(12): 577-581, 2010.
Article
in Chinese
| WPRIM
| ID: wpr-254755
ABSTRACT
<p><b>OBJECTIVE</b>To compare a side-to-side esophagogastric anastomosis with conventional hand-sewn or stapled esophagogastrostomy for prevention of anastomotic stricture by randomized clinical trial.</p><p><b>METHODS</b>Between November 2007 and September 2008, 160 patients with esophageal carcinoma or gastric cardia cancer were consecutively admitted and underwent surgical treatment. After excluding 5 patients (2 refused to participate in and 3 did not meet inclusion criteria), the remaining 155 patients were completely randomized to receive either a side-to-side esophagogastric anastomosis (SS group), or the conventional hand-sewn (HS group), or a circular stapled (CS group) anastomosis, after the removal of esophageal tumor. The primary outcome measured the incidence of anastomotic stricture at 3 months after the operation (defined as the diameter of the anastomotic orifice <or= 0.8 cm on esophagogram), analyzed by intention-to-treat.</p><p><b>RESULTS</b>There was 1 operative death (in HS group) and 1 simple exploration (in SS group). The anastomotic leakage was observed in 4 patients (2 cervical and 1 intrathoracic leaks in HS group, and 1 intrathoracic leak in CS group). The follow-up rate was 96.1% (1 patient in SS group, 3 in HS group, and 2 in CS group were lost). Finally 45 patients in SS group, 52 in HS group, and 47 in CS group were included in the analysis. The 3 groups were preoperative similar. The anastomotic stricture rate was 0% (0/45) in SS group, 9.6% (5/52) in HS group, and 19.1% (9/47) in CS group, respectively (Fisher exact probability test, P = 0.005). The reflux/regurgitation score among 3 groups was similar (chi(2) = 1.681, P = 0.432).</p><p><b>CONCLUSION</b>The side-to-side esophagogastric anastomosis could prevent stricture formation, without increasing gastroesophageal reflux.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Postoperative Complications
/
Stomach
/
Stomach Neoplasms
/
General Surgery
/
Esophageal Neoplasms
/
Anastomosis, Surgical
/
Cardia
/
Follow-Up Studies
/
Constriction, Pathologic
/
Esophagus
Type of study:
Controlled clinical trial
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
Chinese
Journal:
Chinese Journal of Surgery
Year:
2010
Type:
Article
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