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Stapled vs handsewn anastomosis and anastomotic leaks in gastric cancer surgery-a population-based nationwide study in Finland.
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.
Afiliación
  • Kvist E; Surgery Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. Electronic address: elina.kvist@student.oulu.fi.
  • Helminen O; Surgery Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
  • Helmiö M; Division of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland.
  • Huhta H; Surgery Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
  • Jalkanen A; Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  • Junttila A; Department of Surgery, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland.
  • Kallio R; Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland.
  • Koivukangas V; Surgery Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
  • Kokkola A; Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  • Laine S; Division of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland.
  • Lietzen E; Division of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland.
  • Louhimo J; Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  • Meriläinen S; Surgery Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
  • Pohjanen VM; Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.
  • Rantanen T; Department of Surgery, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland.
  • Ristimäki A; Department of Pathology, HUSLAB, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Applied Tumor Genomics Research Program, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
  • Räsänen JV; Department of General Thoracic and Oesophageal Surgery, Heart and Lung Centre, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  • Saarnio J; Surgery Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
  • Sihvo E; Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland.
  • Toikkanen V; Department of Cardiothoracic Surgery, Heart Center, Tampere University Hospital and University of Tampere, Tampere, Finland.
  • Tyrväinen T; Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
  • Valtola A; Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.
  • Kauppila JH; Surgery Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Molecular Medicine and Surgery, Karolinska Institutet and Karolinska University, Stockholm, Sweden.
J Gastrointest Surg ; 28(6): 820-823, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38599994
ABSTRACT

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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Gástricas / Anastomosis Quirúrgica / Grapado Quirúrgico / Fuga Anastomótica / Gastrectomía Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: J Gastrointest Surg Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Gástricas / Anastomosis Quirúrgica / Grapado Quirúrgico / Fuga Anastomótica / Gastrectomía Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: J Gastrointest Surg Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos