title: Manual compared with mechanical cervical oesophagogastric anastomosis: a randomised trial.
abstract: OBJECTIVE
  To compare the short and medium term result of hand-sewn and stapled anastomoses after oesophagectomy.
  
  
  METHODS
  Randomised study.
  
  
  METHODS
  Teaching hospital, Italy.
  
  
  METHODS
  41 patients who required oesophagectomy between February 1993 and December 1996.
  
  
  METHODS
  Oesophagectomy and left cervical gastroplasty.
  
  
  METHODS
  Mortality and morbidity.
  
  
  RESULTS
  21 patients were randomised to have the anastomosis hand-sewn, and 20 to have it stapled. The two groups were comparable. 3 patients died in hospital (2 in the hand-sewn and 1 in the stapled group), and the remainder were followed up a mean of 21 months (range 6-34). There was one clinical leak in the hand-sewn group compared with 3 in the stapled group, and 1 further radiological leak in the stapled group. 2 patients in the hand-sewn and 3 in the stapled group developed strictures.
  
  
  CONCLUSIONS
  Though the numbers are too small to be assessed statistically, we think that these result are sufficient to persuade us that oesophagogastric anastomoses should be hand-sewn rather than stapled.
authors.affiliation: First Division of General Surgery, Istituto di Semeiotica Chirurgica, University of Verona, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Laterza
authors.forename: G
authors.initials: G
authors.lastname: de' Manzoni
authors.forename: G F
authors.initials: GF
authors.lastname: Veraldi
authors.forename: A
authors.initials: A
authors.lastname: Guglielmi
authors.forename: P
authors.initials: P
authors.lastname: Tedesco
authors.forename: C
authors.initials: C
authors.lastname: Cordiano
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D004938:Esophageal Neoplasms / Q000601:surgery; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017792:Surgical Stapling; D013536:Suture Techniques