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Wang Q, He XR, Shi CH, et al. Hand-Sewn Versus Stapled Esophagogastric Anastomosis in the Neck: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Indian J Surg. 2013;77(2):133-40doi: 10.1007/s12262-013-0984-3.
Wang, Q., He, X. R., Shi, C. H., Tian, J. H., Jiang, L., He, S. L., & Yang, K. H. (2015). Hand-Sewn Versus Stapled Esophagogastric Anastomosis in the Neck: A Systematic Review and Meta-analysis of Randomized Controlled Trials. The Indian journal of surgery, 77(2), 133-40. https://doi.org/10.1007/s12262-013-0984-3
Wang, Quan, et al. "Hand-Sewn Versus Stapled Esophagogastric Anastomosis in the Neck: A Systematic Review and Meta-analysis of Randomized Controlled Trials." The Indian journal of surgery vol. 77,2 (2015): 133-40. doi: https://doi.org/10.1007/s12262-013-0984-3
Wang Q, He XR, Shi CH, Tian JH, Jiang L, He SL, Yang KH. Hand-Sewn Versus Stapled Esophagogastric Anastomosis in the Neck: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Indian J Surg. 2015 Apr;77(2):133-40. doi: 10.1007/s12262-013-0984-3. Epub 2013 Oct 09. PMID: 26139968; PMCID: PMC4484531.
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Indian J Surg. 2015 Apr;77(2):133-40. doi: 10.1007/s12262-013-0984-3. Epub 2013 Oct 09.

Hand-Sewn Versus Stapled Esophagogastric Anastomosis in the Neck: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

The Indian journal of surgery

Quan Wang, Xi-Ran He, Chun-Hu Shi, Jin-Hui Tian, Lin Jiang, Sheng-Liang He, Ke-Hu Yang

Affiliations

  1. Evidence-Based Medicine Center, School of Basic Medical Science, Lanzhou University, Lanzhou, China ; The First Clinical Medical College of Lanzhou University, Lanzhou University, Lanzhou, China.
  2. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China.
  3. Evidence-Based Medicine Center, School of Basic Medical Science, Lanzhou University, Lanzhou, China.
  4. The First Clinical Medical College of Lanzhou University, Lanzhou University, Lanzhou, China.

PMID: 26139968 PMCID: PMC4484531 DOI: 10.1007/s12262-013-0984-3

Abstract

The application of cervical esophagogastric anastomoses was of great concern. However, between circular stapler (CS) and hand-sewn (HS) methods with anastomosis in the neck, which one has better postoperative effects still puzzles surgeons. This study aims to systematically evaluate the effectiveness, security, practicality, and applicability of CS compared with the HS method for the esophagogastric anastomosis after esophageal resection. A systematic literature search, as well as other additional resources, was performed which was completed in January 2013. The relevant randomized controlled trials (RCTs) about the surgical technique for esophageal resection were included. Trial data was reviewed and extracted independently by two reviewers. The quality of the included studies was assessed by the recommended standards basing on Cochrane handbook 5.1.0, and the data was analyzed via RevMan 5 software (version 5.2.0). Nine studies with 870 patients were included. The results showed that in comparing HS to CS methods with cervical anastomosis, no significant differences were found in the risk of developing anastomotic leakages (relative risk (RR) = 1.30, 95 % confidence intervals (CI) 0.87-1.92, p = 0.20), as well as the anastomosis stricture (RR = 0.97, 95 % CI 0.47-1.99, p = 0.93), postoperative mortality (RR = 0.83, 95 % CI 0.43-1.58, p = 0.57), blood loss (mean difference (MD) = 39.68; 95 % CI -6.97, 86.33; p = 0.10) and operative time (MD = 18.05; 95 % CI -3.22, 39.33; p = 0.10). However, the results also illustrated that the CS methods with cervical anastomosis might be less time-consuming and have shorter hospital stay and higher costs. Based upon this meta-analysis, there were no differences in the postoperative outcomes between HS and CS techniques. And the ideal technique of cervical esophagogastric anastomosis following esophagectomy remains under controversy.

Keywords: Cervical anastomosis; Circular stapler; Esophagectomy; Hand-sewn; Meta-analysis; Systematic review

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