Abstract

Background

Current evidence on the benefits of different anastomotic techniques (hand‐sewn (HS), circular stapled (CS), triangulating stapled (TS) or linear stapled/semimechanical (LSSM) techniques) after oesophagectomy is conflicting. The aim of this study was to evaluate the evidence for the techniques for oesophagogastric anastomosis and their impact on perioperative outcomes.

Methods

This was a systematic review and network meta‐analysis. PubMed, EMBASE and Cochrane Library databases were searched systematically for randomized and non‐randomized studies reporting techniques for the oesophagogastric anastomosis. Network meta‐analysis of postoperative anastomotic leaks and strictures was performed.

Results

Of 4192 articles screened, 15 randomized and 22 non‐randomized studies comprising 8618 patients were included. LSSM (odds ratio (OR) 0·50, 95 per cent c.i. 0·33 to 0·74; P = 0·001) and CS (OR 0·68, 0·48 to 0·95; P = 0·027) anastomoses were associated with lower anastomotic leak rates than HS anastomoses. LSSM anastomoses were associated with lower stricture rates than HS anastomoses (OR 0·32, 0·19 to 0·54; P < 0·001).

Conclusion

LSSM anastomoses after oesophagectomy are superior with regard to anastomotic leak and stricture rates.

Details

Title
Anastomotic techniques for oesophagectomy for malignancy: systematic review and network meta‐analysis
Author
Kamarajah, S K 1 ; Bundred, J R 2 ; Singh, P 3   VIAFID ORCID Logo  ; Pasquali, S 4 ; Griffiths, E A 5 

1  Department of Hepatobiliary, Pancreatic and Transplant Surgery, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; Institute of Cellular Medicine, University of Newcastle, Newcastle upon Tyne, UK 
2  College of Medical and Dental Sciences, Birmingham, UK; Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK 
3  Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; Regional Oesophago‐Gastric Unit, Royal Surrey NHS Foundation Trust, Guildford, UK 
4  Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy 
5  Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK; Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK 
Pages
563-576
Section
Systematic reviews
Publication year
2020
Publication date
Aug 2020
Publisher
Oxford University Press
e-ISSN
24749842
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1002/bjs5.50298
ProQuest document ID
2463834234
Copyright
© 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.