Author:
Milone Marco,Bianchi Paolo Pietro,Cianchi Fabio,Coratti Andrea,D’Amore Anna,De Manzoni Giovanni,De Pasqual Carlo Alberto,Formisano Giampaolo,Jovine Elio,Morelli Luca,Offi Mariafortuna,Peri Andrea,Pietrabissa Andrea,Staderini Fabio,Tribuzi Angela,Giacopuzzi Simone
Abstract
Abstract
Background
The aim of the present study is to compare outcomes of the robotic hand-sewn, linear- and circular-stapled techniques performed to create an intrathoracic esophagogastric anastomosis in patients who underwent Ivor-Lewis esophagectomy.
Methods
Patients who underwent a planned Ivor-Lewis esophagectomy were retrospectively analysed from prospectively maintained databases. Only patients who underwent a robotic thoracic approach with the creation of an intrathoracic esophagogastric anastomosis were included in the study. Patients were divided into three groups: hand-sewn-, circular stapled-, and linear-stapled anastomosis group. Demographic information and surgery-related data were extracted. The primary outcome was the rate of anastomotic leakages (AL) in the three groups. Moreover, the rate of grade A, B and C anastomotic leakage were evaluated. In addition, patients of each group were divided in subgroups according to the characteristics of anastomotic fashioning technique.
Results
Two hundred and thirty patients were enrolled in the study. No significant differences were found between the three groups about AL rate (p = 0.137). Considering the management of the AL for each of the three groups, no significant differences were found. Evaluating the correlation between AL rate and the characteristics of anastomotic fashioning technique, no significant differences were found.
Conclusions
No standardized anastomotic fashioning technique has yet been generally accepted. This study could be considered a call to perform ad hoc high-quality studies involving high-volume centers for upper gastrointestinal surgery to evaluate what is the most advantageous anastomotic technique.
Funder
Università degli Studi di Napoli Federico II
Publisher
Springer Science and Business Media LLC