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Hand-Sewn Versus Stapled Oesophago-gastric Anastomosis: Systematic Review and Meta-analysis

  • Review Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Objective

In this meta-analysis, data from relevant randomised controlled trials has been pooled together to gain a consensus in the comparison of outcome following hand-sewn versus stapled oesophago-gastric (OG) anastomoses.

Methods

Medline, Embase, Cochrane, trial registries, conference proceedings and reference lists were searched for randomised controlled trials comparing hand-sewn and stapled OG anastomoses. Primary outcome measures were 30-day mortality, anastomotic leakage and stricture. Secondary outcomes were operative time, cardiac complications and pulmonary complications.

Results

Nine randomised trials were included in this meta-analysis. There was no significant difference between the groups for 30-day mortality (pooled odds ratio = 1.71; 95% CI = 0.822 to 3.56; P = 0.15) and anastomotic leakage (pooled odds ratio = 1.06; 95% CI = 0.62 to 1.80; P = 0.83). There was a significantly increased rate of anastomotic stricture associated with stapled OG anastomosis (pooled odds ratio = 1.76; 95% CI = 1.09 to 2.86; P = 0.02).

Discussion

Meta-analysis of randomised controlled trials comparing hand-sewn with stapled OG anastomosis demonstrates that a stapled anastomosis is associated with a shorter operative time but with an increased rate of post-operative anastomotic stricture.

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Authors and Affiliations

  1. Department of General Surgery, University College London Hospital, 235 Euston Road, London, UK

    Sheraz R. Markar, Soumil Vyas, Majid Hashemi & Mark Winslet

  2. Department of General Surgery, Chelsea and Westminster NHS Foundation Trust, London, UK

    Alan Karthikesalingam

  3. Department of General Surgery, Royal Free Hampstead Hospital, London, UK

    Mark Winslet

Authors
  1. Sheraz R. Markar
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  2. Alan Karthikesalingam
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  3. Soumil Vyas
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  4. Majid Hashemi
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  5. Mark Winslet
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Corresponding author

Correspondence to Sheraz R. Markar.

Additional information

Poster Presentation at Association for Upper Gastro-Intestinal Surgeons of Great Britain and Ireland, Oxford University, September 2010.

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Markar, S.R., Karthikesalingam, A., Vyas, S. et al. Hand-Sewn Versus Stapled Oesophago-gastric Anastomosis: Systematic Review and Meta-analysis. J Gastrointest Surg 15, 876–884 (2011). https://doi.org/10.1007/s11605-011-1426-9

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  • DOI: https://doi.org/10.1007/s11605-011-1426-9

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