Comparison Of Anastomosis Leakage And Stricture Of Layered And Stapler Esophagogastric Anastomosis For Cancer: A Prospective Randomized Controlled Trial

Objective:To compare the postoperative Anastomosis Leakage and Stricture using Layered and Stapler Esophagogastric Anastomosis for esophageal or gastric cardiac carcinoma.Methods:A prospective randomized controlled trial was undertaken in 516 patients with resectable cancer of esophageal or gastric cardiac carcinoma from May 2002 to December 2007. Patients were randomized to receive either layered manual (244 patients) or circular stapled (272 patients) after resection for esophageal or gastric cardiac carcinoma.Results:Anastomotic leakage was noted in one patients (0.4%) in layered group and six patients (2.9%) in the stapler group (P=0.168). After the operation, two patients (0.8%) in layered group and thirteen patients (4.8%) in the stapler group developed a benign esophageal stricture (P=0.016). The mean follow-up time was more than 12 months.Conclusions:Compared with the stapler anastomosis, the layered esophagogastric anastomosis could reduce the incidence of anastomotic stricture with the significant statistical differences while anastomotic leakage without the significant statistical differences after esophagectomy. It is easy to apply and could be used as an alternative for esophagogastric anastomosis after resection for esophageal or cardiac carcinoma.