Impact of Circular Stapler Size on Short-Term Outcomes and Long-Term Quality of Life After McKeown Esophagectomy.

Background: The circular stapling technique (CST) is reported to be a simple and time-efficient method; however, it is associated with a high incidence of anastomotic stenosis for McKeown esophagectomy. Meanwhile, the impact of circular stapler size remains controversial. We aimed to investigate the impact of circular stapler size on both short-term outcomes and long-term quality of life (QOL) after McKeown esophagectomy. Methods: In total, 63 consecutive patients who underwent McKeown esophagectomy for esophageal cancer between 2019 and 2022 were eligible. We examined the association between circular stapler size and short-term outcomes and long-term QOL using the PGSAS-37. Results: 35 (55.6%) patients underwent anastomosis with a 21 mm stapler, whereas 28 (44.4%) patients used a 23 mm stapler. No significant differences were observed between the groups. The incidence of anastomotic leakage did not differ significantly between the groups (5.7% vs. 7.1%, Conclusions: Short-term outcomes did not differ between patients who underwent anastomosis with a 21 mm stapler and those with a 23 mm stapler, however QOL, particularly the feeling of dysphagia, was worse in patients who used a 21 mm stapler compared to those who used a 23 mm stapler.