ArticleAnnals of surgery open : perspectives of surgical history, education, and clinical approaches2022
Effect of Circular Stapler Diameter on Anastomotic Leakage Rate and Stenosis After Open Total Gastrectomy With Esophagojejunostomy: A Substantive Retrospective Propensity Score Matched Series.
Article in Annals of surgery open : perspectives of surgical history, education, and clinical approaches, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 5 citations in OpenAlex.
- Factors associated with esophagojejunostomy stricture and its clinical impact after gastrectomy: a 10-year single-center study.Langenbeck's archives of surgery · 2026Article
- Smaller Circular Staplers Do Not Compromise Postoperative Quality of Life in Esophagojejunostomy: A CT-Based Clinical Trial.Annals of surgical oncology · 2026Observational
- Impact of Anastomotic Leak on Long-Term Survival After Gastrectomy: Results from an Individual Patient Data Meta-Analysis.Cancers · 2025Review
- [Modern approaches and technologies to prevent anastomotic leakage in the gastrointestinal tract].Chirurgie (Heidelberg, Germany) · 2024Article
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Anastomotic leakage (AL) and stenosis (AS) are two of the most severe postoperative complications after total gastrectomy with esophagojejunostomy. The stapler diameter can be chosen by the surgeon. Therefore, this study aims to assess the correlation between the stapler size as main independent variable as well as other different risk factors and AL and AS. Methods: We conducted a retrospective analysis of data from 356 patients who underwent open total gastrectomy between 2000 and 2018, mostly due to gastric cancer (96.9%). After propensity score matching the outcome parameters AL and AS were compared between the two stapler size groups. We also assessed different risk factors for AL and AS in cancer patients using multivariate analysis. Results: Small circular stapler diameter (21/25 mm; n = 147 vs 28/29/31 mm; n = 209) was identified as a significant risk factor for the occurrence of AL (10% vs 4% for smaller vs larger staplers; Conclusion: The application of a larger circular stapler for esophagojejunostomy in open total gastrectomy shows significantly lower rates of AL and stenosis. Therefore, the largest possible stapler diameter should be applied.
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