PDF(Pubmed)
Abstract：
For patients undergoing an Ivor Lewis esophagectomy with a circular stapled anastomosis, the optimal diameter of the used circular stapler to restore continuity is unknown. The aim of this study was to compare the 25 mm stapled versus the 28 mm stapled esophagogastric anastomosis after Ivor Lewis esophagectomy, focusing on anastomotic insufficiency and postoperative anastomotic strictures.
Between February 2008 and June 2019, 349 consecutive patients underwent Ivor Lewis esophagectomy with gastric conduit reconstruction and circular stapled anastomosis. Patient characteristics and postoperative results, such as anastomotic insufficiency rates, postoperative anastomotic stricture rates, time to anastomotic stricture rate, and the number of dilatations, were recorded in a prospective database and analyzed.
In 222 patients (64%), the 25 mm circular stapler was used and in 127 patients (36%) the 28 mm circular stapler was used. There were no differences in baseline characteristics. Anastomotic insufficiency rates were comparable between the 25 mm (12%) and the 28 mm groups (11%) (p = 0.751). There were no differences between postoperative anastomotic strictures in the 25 mm (14%) and the 28 mm groups (14%) (p = 0.863). Within patients with postoperative anastomotic strictures, a median number of 2 dilatations were observed in each group (p = 0.573) without differences in the time to first diagnosis (p = 0.412).
There were no differences in anastomotic insufficiency and postoperative anastomotic stricture rates between the 25 mm and the 28 mm circular stapled esophagogastric anastomosis after Ivor Lewis esophagectomy. Both the 25 mm and 28 mm stapler can be safely used to create a circular stapled esophagogastric anastomosis to restore continuity after esophagectomy.
Between February 2008 and June 2019, 349 consecutive patients underwent Ivor Lewis esophagectomy with gastric conduit reconstruction and circular stapled anastomosis. Patient characteristics and postoperative results, such as anastomotic insufficiency rates, postoperative anastomotic stricture rates, time to anastomotic stricture rate, and the number of dilatations, were recorded in a prospective database and analyzed.
In 222 patients (64%), the 25 mm circular stapler was used and in 127 patients (36%) the 28 mm circular stapler was used. There were no differences in baseline characteristics. Anastomotic insufficiency rates were comparable between the 25 mm (12%) and the 28 mm groups (11%) (p = 0.751). There were no differences between postoperative anastomotic strictures in the 25 mm (14%) and the 28 mm groups (14%) (p = 0.863). Within patients with postoperative anastomotic strictures, a median number of 2 dilatations were observed in each group (p = 0.573) without differences in the time to first diagnosis (p = 0.412).
There were no differences in anastomotic insufficiency and postoperative anastomotic stricture rates between the 25 mm and the 28 mm circular stapled esophagogastric anastomosis after Ivor Lewis esophagectomy. Both the 25 mm and 28 mm stapler can be safely used to create a circular stapled esophagogastric anastomosis to restore continuity after esophagectomy.
摘要：
对于接受IvorLewis食管切除术并进行圆形吻合术的患者，使用的圆形订书机恢复连续性的最佳直径是未知的。这项研究的目的是比较IvorLewis食管切除术后25mm吻合术和28mm吻合术。重点关注吻合口功能不全和术后吻合口狭窄。
2008年2月至2019年6月，349例连续患者接受了IvorLewis食管切除术，胃导管重建和环形吻合术。患者特征和术后结果，如吻合口功能不全，术后吻合口狭窄率，时间吻合口狭窄率，以及扩张的次数，记录在前瞻性数据库中并进行分析。
在222名患者（64%）中，使用25mm圆形吻合器,127例(36%)患者使用28mm圆形吻合器.基线特征没有差异。25mm组（12％）和28mm组（11％）之间的吻合口不全发生率相当（p=0.751）。25mm（14％）和28mm组（14％）的术后吻合口狭窄之间没有差异（p=0.863）。在术后吻合口狭窄的患者中，每组中观察到2次扩张的中位数(p=0.573),在首次诊断的时间上没有差异(p=0.412).
IvorLewis食管切除术后25mm和28mm环形吻合术的吻合口功能不全和术后吻合口狭窄率无差异。25mm和28mm吻合器都可以安全地用于创建圆形的食管胃吻合术，以恢复食管切除术后的连续性。
2008年2月至2019年6月，349例连续患者接受了IvorLewis食管切除术，胃导管重建和环形吻合术。患者特征和术后结果，如吻合口功能不全，术后吻合口狭窄率，时间吻合口狭窄率，以及扩张的次数，记录在前瞻性数据库中并进行分析。
在222名患者（64%）中，使用25mm圆形吻合器,127例(36%)患者使用28mm圆形吻合器.基线特征没有差异。25mm组（12％）和28mm组（11％）之间的吻合口不全发生率相当（p=0.751）。25mm（14％）和28mm组（14％）的术后吻合口狭窄之间没有差异（p=0.863）。在术后吻合口狭窄的患者中，每组中观察到2次扩张的中位数(p=0.573),在首次诊断的时间上没有差异(p=0.412).
IvorLewis食管切除术后25mm和28mm环形吻合术的吻合口功能不全和术后吻合口狭窄率无差异。25mm和28mm吻合器都可以安全地用于创建圆形的食管胃吻合术，以恢复食管切除术后的连续性。
