Outcomes Of Stapled Versus Hand Sewn Oesophagojejunal Anastomosis after Total Gastrectomy: A Retrospective Study
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 12
Abstract
Aim: Oesophagojejunostomy is the major cause of morbidity following total gastrectomy for malignancy. This study was done to compare the short term and long term outcomes between stapled versus hand sewn oesophagojejunal anastomosis after total gastrectomy for oesophagogastric junction carcinoma and proximal gastric carcinoma. Methods:This is a retrospective study of 63 patients who underwent total gastrectomy for adenocarcinoma of OG junction & proximal stomach at the Institute of Surgical Gastroenterology, Centre of Excellence for Upper Gastrointestinal Surgery, Rajiv Gandhi Government General hospital, Chennai from August 2014 to July 2017. The study population was divided into two arms: Stapled oesophagojejunal anastomosis arm (48 patients) and Hand-sewn oesophagojejunal anastomosis arm (15 patients). Anastomotic techniques and postoperative complications were defined. Analysis of various parameters was done based on data obtained from prospectively maintained database and periodic patient reviews. Statistical analysis was performed using SPSS software and p value of <0.05 was considered to be statistically significant. Results: The mean age of the patients was 51.7 years (range: 26 to 70 years). Majority (87%) of the patients had dysphagia at presentation. The two groups were comparable in terms of presenting symptoms, comorbidities, behavioural and dietary habits, biochemical parameters and stage of the disease. The handsewn group had longer operative times (208 min vs 170 min), more blood loss (201 ml vs 168ml), delay in NG tube removal (11.67 days vs 6.42 days), delay in initiation of oral intake (10 days vs 6 days), delay in drain removal (12.4 days vs 7.4 days) and prolonged postop hospital stay (15.6 days vs 9.52 days), which were all statistically significant. The incidence of anastomotic leak, anastomotic stricture, wound infections, transfusion requirement and mortality were not statistically significant between the two groups. Conclusion: Stapled esophagojejunal anastomosis is a safe way to create an oesophagojejunal anastomosis, allowing shorter operating time, early initiation of orals and shorter hospital stay when compared with handsewn anastomosis.
Authors and Affiliations
Chinnusamy Kolandasamy, Balaraman Kesavan, S. M. Satish Deva kumar, Mohan Karthikeyan, S. Rajendran, O. L. Naganath Babu
Keywords
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- EP ID EP423871
- DOI 10.9790/0853-1712075461.
- Views 47
- Downloads 0
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