Comparison of Complications and Morbidity between Hand-Sewn and Stapled Anastomosis after Transhiatal Esophagectomy in Patients with Esophageal Cancer.

Abstract

Background: With the increasing adoption of minimally invasive techniques in esophageal cancer (EC) surgery, comparing the complications and morbidity between hand-sewn anastomosis (HSA) and stapled anastomosis (SA) after transhiatal esophagectomy (THE) is of significant clinical importance. This study aimed to evaluate these two techniques in terms of postoperative complications, anastomotic leakage, hospital stay, and other related outcomes.

Methods: This retrospective cohort study included 110 patients with EC who underwent THE at Shahid Beheshti Hospital. Patients were divided into two groups: those undergoing HSA and those undergoing SA. Demographic, surgical, and postoperative complication data were extracted from medical records and analyzed using SPSS software version 25. Quantitative variables were compared using the independent t-test, while qualitative variables were assessed using the chi-square or Fisher's exact test. A P value<0.05 was considered statistically significant.

Results: The results indicated that while the stapled method showed superiority in reducing recovery time and short-term complications, there was no significant difference in readmission rates between the two groups. This aligns with the findings of Law and colleagues, which suggest that readmission rates and disease recurrence are similar across different surgical methods.

Conclusion: Both anastomosis techniques are comparable in terms of safety and potential for reoperation; however, further research is needed to investigate long-term complications. The findings of this study highlight the impact of body mass index and readmission rates on the choice of surgical method. Future research should address these discrepancies and include larger, more diverse populations in long-term assessments to achieve more definitive results regarding the comparative effectiveness of these techniques.