title: [Comparison of the stapled suture with the manual suture in the application of minimally invasive esophagectomy].
abstract: OBJECTIVE
  To compare the associated anastomotic complication of cervical esophagogastric anastomosis between stapled and hand-sewn anastomosis in minimally invasive esophagectomy(MIE).
  
  
  METHODS
  Clinical data of 203 patients with esophageal cancer receiving combined thoracoscopic and laparoscopic esophagectomy with anastomosis in the neck in our hospital from January 2010 to November 2013 were retrospectively analyzed. All the patients were divided into stapled group(104 patients) and hand-sewn group(99 patients). The incidence of anastomotic leakage and anastomotic stricture between these two groups were compared.
  
  
  RESULTS
  There were no significant differences between two groups in gender, age, body mass index, total protein, albumin, and neoadjuvant chemotherapy(all P>0.05). There was no significant difference between the two groups in the incidence of anastomotic leakage [6/104(5.77%) vs. 3/99(3.03%), P>0.05], while the difference in the incidence of anastomotic stricture was significant [10/104(9.62%) vs. 2/99(2.02%), P<0.05]. The time of anastomosis, dieting and hospital stay was (15.5±5.0) min, (5.0±2.8) d and (18.3±5.9) d in stapled group, which was significantly shorter than (28.0±4.5) min, (5.9±1.2) d and (21.8±4.2) d in hand-sewn group(all P<0.05).
  
  
  CONCLUSIONS
  In the minimally invasive esophagectomy, stapled cervical esophagogastric anastomosis is simple and precise, but it is associated with increased risk of anastomotic stricture, therefore the type of anastomosis should be chosen based on the conditions of the patient.
authors.affiliation: Department of Thoracic Surgery, Fujian Provincial Tumor Hospital, Fuzhou 350014, China. shuoyanliu2010@163.com.
authors.forename: Feng
authors.initials: F
authors.lastname: Wang
authors.forename: Shuoyan
authors.initials: S
authors.lastname: Liu
authors.forename: Jianjian
authors.initials: J
authors.lastname: Wang
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Chen
authors.forename: Qingfeng
authors.initials: Q
authors.lastname: Zheng
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.forename: Jianjian
authors.initials: J
authors.lastname: Xu
authors.forename: Saiyun
authors.initials: S
authors.lastname: Chen
mesh_terms: D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000209:etiology; D003251:Constriction, Pathologic / Q000209:etiology; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D013537:Sutures; D016896:Treatment Outcome