title: Albert-Lembert versus hybrid-layered suture in hand sewn end-to-end cervical esophagogastric anastomosis after esophageal squamous cell carcinoma resection.
abstract: BACKGROUND
  Hand sewn cervical esophagogastric anastomosis (CEGA) is regarded as preferred technique by surgeons after esophagectomy. However, considering the anastomotic leakage and stricture, the optimal technique for performing this anastomosis is still under debate.
  
  
  METHODS
  Between November 2010 and September 2012, 230 patients who underwent esophagectomy with hand sewn end-to-end (ETE) CEGA for esophageal squamous cell carcinoma (ESCC) were analyzed retrospectively, including 111 patients underwent Albert-Lembert suture anastomosis and 119 patients underwent hybrid-layered suture anastomosis. Anastomosis construction time was recorded during operation. Anastomotic leakage was recorded through upper gastrointestinal water-soluble contrast examination. Anastomotic stricture was recorded during follow up.
  
  
  RESULTS
  The hybrid-layered suture was faster than Albert-Lembert suture (29.40±1.24 min vs. 33.83±1.41 min, P=0.02). The overall anastomotic leak rate was 7.82%, the leak rate in hybrid-layered suture group was significantly lower than that in Albert-Lembert suture group (3.36% vs. 12.61%, P=0.01). The overall anastomotic stricture rate was 9.13%, the stricture rate in hybrid-layered suture group was significantly lower than that in Albert-Lembert suture group (5.04% vs. 13.51%, P=0.04).
  
  
  CONCLUSIONS
  Hand sewn ETE CEGA with hybrid-layered suture is associated with lower anastomotic leakage and stricture rate compared to hand sewn ETE CEGA with Albert-Lembert suture.
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Feng
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Li
authors.initials: L
authors.lastname: Sun
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Guanghui
authors.initials: G
authors.lastname: Xu
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Liu
authors.initials: L
authors.lastname: Hong
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Cai
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Guocai
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Man
authors.initials: M
authors.lastname: Guo
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Lian
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Zhang
keywords: Hand sewn anastomosis; cervical esophagogastric anastomosis (CEGA); end-to-end anastomosis; esophageal squamous cell carcinoma (ESCC); esophagectomy