A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Stapled vs handsewn anastomosis and anastomotic leaks in gastric cancer surgery-a population-based nationwide study in Finland
Tekijät: Kvist Elina, Helminen Olli, Helmiö Mika, Huhta Heikki, Jalkanen Aapo, Junttila Anna, Kallio Raija, Koivukangas Vesa, Kokkola Arto, Laine Simo, Lietzen Elina, Louhimo Johanna, Meriläinen Sanna, Pohjanen Vesa-Matti, Rantanen Tuomo, Ristimäki Ari, Räsänen Jari V., Saarnio Juha, Sihvo Eero, Toikkanen Vesa, Tyrväinen Tuula, Valtola Antti, Kauppila Joonas H.; on behalf of the FINEGO group
Kustantaja: Springer Nature
Julkaisuvuosi: 2024
Journal: Journal of Gastrointestinal Surgery
Tietokannassa oleva lehden nimi: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
Lehden akronyymi: J Gastrointest Surg
Vuosikerta: 28
Numero: 6
Aloitussivu: 820
Lopetussivu: 823
ISSN: 1091-255X
eISSN: 1873-4626
DOI: https://doi.org/10.1016/j.gassur.2024.03.005
Verkko-osoite: https://doi.org/10.1016/j.gassur.2024.03.005
Rinnakkaistallenteen osoite: https://research.utu.fi/converis/portal/detail/Publication/387647213
Background: There is a lack of evidence regarding anastomotic technique and postoperative complications in gastric cancer surgery. This study aimed to evaluate whether there are differences between stapled and handsewn anastomosis and anastomotic leaks.
Methods: This was a population-based, retrospective, nationwide cohort study in Finland using the Finnish National Esophago-Gastric Cancer Cohort. Patients undergoing gastrectomy with available postoperative complication data were included. Logistic regression analysis was used to calculate the odds ratios with 95% CIs, adjusted for calendar period of surgery, age at surgery, sex, comorbidity, tumor stage, neoadjuvant therapy, minimally invasive surgery, type of gastrectomy, radical resection, and type of anastomosis.
Results: Of the 2164 patients, 472 of all patients (21.8%) had handsewn anastomosis and 1692 of all patients (78.2%) had stapled anastomosis. In the unadjusted analysis, anastomotic leaks were significantly lower in the handsewn group (hazard ratio [HR], 0.42; 95% CI, 0.22-0.79) than the stapled group, but after adjustment for known prognostic factors, this association was no longer significant (HR, 0.57; 95% CI, 0.27-1.21). In the analysis stratified by gastrectomy type (distal or total), no differences in anastomotic leaks were observed between anastomotic techniques.
Conclusion: In this population-based nationwide study, anastomotic technique (stapled or handsewn) was not associated with anastomotic leaks in any, distal or total, gastrectomy.
Ladattava julkaisu This is an electronic reprint of the original article. |
Julkaisussa olevat rahoitustiedot:
This study was funded by the Finnish State Research Funding (J. H. K.), Finnish Cancer Foundation (J. H. K.), Päivikki and Sakari Sohlberg Foundation (J. H. K.), and Sigrid Juselius Foundation (J. H. K.). The funding sources have no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the study protocol for publication.