Your browser doesn't support javascript.
loading
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>
Subject(s)
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

Similar

MEDLINE

...
LILACS

LIS

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