Abstract
BackgroundThe delta-shaped anastomosis has been reported to reduce anastomotic complications for a decade. However, little has been written comparing this technique with the circular stapler technique. The objective of this retrospective study was to assess the safety and efficacy of cervical delta-shaped anastomosis after esophagectomy.MethodsMedical records of patients with esophageal squamous cell carcinoma who underwent McKeown (three-incision) esophagectomy between September 2013 and June 2015 were reviewed. Either circular stapled anastomosis (CSA) or delta-shaped anastomosis (DSA) was performed at the cervical stage. The clinical characteristics and short-term outcome were retrospectively assessed to identify the differences between the two groups.ResultsA total of 81 patients were included in this study. The clinical characteristics were similar between the two groups. Cervical anastomotic leakage occurred in 3 (7.7%) of 39 patients in the DSA group and in 8 (19%) of 42 patients in the CSA group (P = 0.197). The average anastomotic orifice width was 16.1 ± 4.9 mm and 11.7 ± 2.2 mm, respectively (P < 0.001). The incidence of anastomotic stenosis was 2.6% (1/39) and 23.5% (10/42) in the DSA and CSA groups, respectively (P = 0.007). There was no significant difference in surgical duration, blood loss, pulmonary complication, postoperative mortality, time of hospitalisation and time of ICU stay between the two groups.ConclusionsDelta-shaped anastomosis may be an effective alternative method for gastroesophageal anastomosis after esophagectomy, with lower incidence of leakage and stenosis.
Highlights
The delta-shaped anastomosis has been reported to reduce anastomotic complications for a decade
We describe our surgical procedure using the delta-shaped anastomosis (DSA) approach to create the cervical anastomosis and examine its efficacy and safety in comparison to circular stapled anastomosis (CSA) in patients undergoing esophagectomy for esophageal cancer (EC)
There was a wider anastomotic orifice in DSA group compared to the CSA group (16.1 ± 4.9 mm vs. 11.7 ± 2.2 mm; P < 0.001)
Summary
The delta-shaped anastomosis has been reported to reduce anastomotic complications for a decade. Little has been written comparing this technique with the circular stapler technique The objective of this retrospective study was to assess the safety and efficacy of cervical delta-shaped anastomosis after esophagectomy. Anastomotic leakage and stricture formation continue to be major challenges after resection of EC They are associated with high mortality and frequently compromise patient quality of life [2, 3]. There were no complications associated with the anastomosis in all nine patients treated with the delta-shaped anastomosis Such technique appears to result in a larger lumen size, shorter operative time, better blood supply, and less anastomosis margin tension. As far as we know, little has been reported comparing the results of delta-shaped anastomosis (DSA) to circular stapled anastomosis (CSA).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
