Complications and Survival in Esophagojejunostomy after Total Gastrectomy; A Comparision of Stapler and Manual Suturing

Gastric cancer is the most common cancer in men and the third most common cancer in women after breast cancer and colon. This study aimed to compare the complications and survival of two manual and suturing and suturing with stapler in esophagojejunostomy suturing followed by total gastrectomy. In this historical cohort study, 116 patients requiring total Gastrectomy were studied with proximal Gastric and Cardia cancer referred to a hospital with census method. Patients were studied by age, gender, type of surgery, leakage and other complications and one-year survival rates during hospitalization and at least 12 months after surgery. Data analyzed by SPSS 20 software and Chi-square, Independent-T tests, Kaplan-Meier and Cox regression. Suturing in 40 patients (34.5%) was manually and in 76 patients (65.5%) was with stapler. In manual suturing, 6 (15%) and in stapler suturing 2 (2.6%) leakage happened, which was statistically different (p=0.18). Mean operation time was 273.9±50.7min in manual suturing and was 252.3±65.8 in stapler suturing which was statistically different (p=0.25). In manual suturing 8 (20%) and in stapler suturing 4 (5.3%) deaths occurred which was statistically different (p=0.009). One-year survival rate was 31% and median survival rate was 15 months. Age and stage of disease had the highest correlation with survival rate. Due to the lower leakage rate and mortality after surgery, manual suturing is more effective than suturing with stapler.