title: Prospective randomized controlled trial comparing the use of 3.5-mm and 4.8-mm staples in gastric surgery.
abstract: OBJECTIVE
  The purpose of this study was to evaluate and compare the use of 4.8-mm and 3.8-mm staples in gastric resection.
  
  
  METHODS
  A series of 60 patients underwent distal or proximal gastrectomy. A 4.8-mm GIA universal stapler was randomly assigned for use in 50% of the patients and a 3.5-mm GIA universal stapler was assigned for use in the remaining 50%.
  
  
  RESULTS
  Bleeding was observed in 20 patients (12 in the 4.8-mm group and eight in the 3.5-mm group). In the 4.8-mm group, bleeding was less frequent in patients with a stomach wall thickness of 7.0-9.0mm. In the 3.5-mm group, bleeding was less frequent in patients with a stomach wall thickness of 5.0-7.0mm. Inappropriate staple formation was observed in patients with thick stomach walls in each group.
  
  
  CONCLUSIONS
  The appropriate staple size for gastric surgery may depend on the thickness of the stomach wall.
authors.affiliation: Department of Surgery, Gastroenterological Center, Yokohama City University, 4-57, Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan. s0714@med.yokohama-cu.ac.jp
authors.forename: Chikara
authors.initials: C
authors.lastname: Kunisaki
authors.forename: Hirochika
authors.initials: H
authors.lastname: Makino
authors.forename: Ryo
authors.initials: R
authors.lastname: Takagawa
authors.forename: Naoto
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Nagano
authors.forename: Shoichi
authors.initials: S
authors.lastname: Fujii
authors.forename: Takashi
authors.initials: T
authors.lastname: Kosaka
authors.forename: Hidetaka A
authors.initials: HA
authors.lastname: Ono
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Akiyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimada
mesh_terms: D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D013528:Surgical Staplers